Related Experiment Video
Updated: May 7, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Surgical management of traumatic extra dural hematoma in children: Experiences and analysis from 24 consecutively
Muhammad Babar Khan1, Muhammad Riaz, Gohar Javed
1Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.
Insights
Falls commonly cause epidural hematoma (EDH) in children. Lower GCS, younger age, delayed surgery, anisocoria, and effaced basal cisterns indicate poorer outcomes in pediatric EDH patients.
Area of Science:
- Pediatric Neurosurgery
- Trauma Surgery
- Neurology
Background:
- Epidural hematoma (EDH) presents uniquely in children compared to adults, impacting treatment and outcomes.
- Understanding pediatric EDH requires specific analysis of injury mechanisms, clinical features, and prognostic factors.
Purpose of the Study:
- To analyze the experiences with EDH in pediatric patients, focusing on injury patterns, presentation, management, and outcomes.
- To identify prognostic indicators for pediatric EDH to improve patient outcomes.
Main Methods:
- Prospective data collection from 24 surgically treated pediatric patients with EDH.
- Analysis included presenting features, radiological imaging, management details, and outcomes (Glasgow Outcome Score - GOS).
- Statistical analysis identified variables significantly associated with GOS.
Main Results:
- Falls were the most frequent cause of EDH in pediatric patients.
- Key prognostic factors associated with poorer GOS included lower Glasgow Coma Scale (GCS) at presentation, younger age, delayed surgical intervention, anisocoria, and effacement of basal cisterns.
- 15 out of 24 patients achieved a GOS score of 5 (excellent outcome) at 3-month follow-up.
Conclusions:
- Falls are the primary cause of EDH in children.
- Factors like low admission GCS, young age, delayed surgery, anisocoria, and effaced basal cisterns predict worse outcomes in pediatric EDH.
- Prompt surgical treatment is crucial for achieving favorable outcomes in pediatric EDH.
Background:
Children with epidural hematoma (EDH) present differently than adults. The outcome of treatment is also different. We aim to report our experiences with EDH in pediatric age group in terms of mode of injury, presenting features, management, and outcomes. We also aim to identify different prognostic indicators in pediatric patients with EDH.
Methods:
We prospectively collected data from 24 consecutively surgically treated pediatric patients. The data collected included presenting features, radiological imaging, details of management, and outcomes. Descriptive analysis was performed and different variables were tested for any statistical significance with Glasgow Outcome Score (GOS).
Results:
There were 19 male and 5 female patients. The mean Glasgow Coma Scale (GCS) score at presentation was 9.3 ± 4.4. Falls were the most common cause of EDH. Outcome assessment was done at 3 month follow up. A total of 15 patients had a GOS score of 5, 4 patients had a GOS score of 4, 2 patients had a GOS score of 3, while 3 patients had a GOS score of 1. On univariate analysis, admitting GCS score, patient's age, the time from injury to admission and injury to surgery, anisocoric pupils at presentation and effacement of basal cisterns were significantly associated with the outcome of GOS score.
Conclusion:
Falls are the most common mode of injury leading to EDH in children. Lower GCS at presentation, younger age at trauma, increased time since trauma to surgery and admission, anisocoria and effacement of basal cisterns are statistically significant variables in surgically treated pediatric patients of EDH that confer a poorer prognosis. A timely surgical intervention can result in excellent outcomes.
