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Pediatric Extradural Hematoma: Clinical Assessment Using King's Outcome Scale for Childhood Head Injury
Muhammad Sohail Umerani1,2, Asad Abbas2,3, Fatima Aziz3
1Department of Neurosurgery, King Fahd Military Medical Complex, Dammam, Saudi Arabia.
Insights
Pediatric epidural hematoma (EDH) is common after head injury. Most children with EDH achieve good recovery, highlighting the importance of prompt surgical intervention for favorable outcomes.
Area of Science:
- Pediatric neurosurgery
- Trauma care
- Neurology
Background:
- Epidural hematoma (EDH) involves traumatic blood accumulation between the skull and dura, often venous in infants.
- EDH is a significant concern in pediatric head injuries.
Purpose of the Study:
- To assess the outcomes of pediatric epidural hematoma (EDH).
- To evaluate pediatric EDH using the King's Outcome Scale for Childhood Head Injury (KOSCHI).
Main Methods:
- Retrospective review of 72 pediatric EDH patient files (January 2012 - December 2014).
- Data collection via predesigned proforma and patient records.
- KOSCHI assessment through telephone interviews.
Main Results:
- The majority of patients (65.3%) were male.
- Road traffic accidents were the primary cause (52.8%), followed by falls and assaults.
- Vomiting (51.4%) was the most frequent symptom; 76.4% of patients achieved a good recovery (KOSCHI score 5b).
Conclusions:
- Pediatric EDH is a notable condition in children with head trauma.
- Suspect EDH in children with skull fractures or scalp hematomas.
- Early surgical intervention is linked to positive long-term outcomes.
Introduction:
Epidural hematoma (EDH) is a traumatic accumulation of blood between the inner table of the skull and the stripped off dural membrane and predominantly consists of venous blood in infants. The study aims to assess the outcome of pediatric EDH using King's Outcome Scale for Childhood Head Injury (KOSCHI).
Materials And Methods:
A total of 72 patients' files were reviewed retrospectively with a diagnosis of EDH from January 2012 to December 2014. Predesigned proforma was filled using data from patient records. In addition, KOSCHI was calculated using recent telephone interviews.
Results:
Among 72 patients, 65.3% were male and 34.7% were female. Overall, road traffic accident was the most common cause (52.8%) followed by fall, assault, and sports injury. The most common symptom was more than two episodes of vomiting which was present in 51.4% of patients followed by loss of consciousness in 37.5%, ENT bleed in 33.3%, headache in 16.7%, and fits in 11.1% of patients. The median follow-up of our patients was 19 (6-40) months. Most of our patients made good recovery with 76.4% of our patients scoring 5b on KOSCHI.
Conclusion:
EDH is not uncommon among children with head injury. It should be suspected in every child with posttraumatic skull fracture or scalp hematoma. Prompt surgical intervention can give good long-term outcome.