Surgical decision in the treatment of extradural haematoma

Extradural haematomas (EH) do not always present with the classical picture of skull trauma followed by a lucid interval, deepening coma, unilateral enlarging pupil and hemiplegia. Symptoms and signs can be puzzling and complex in many cases of EH and may thus lead to dangerous therapeutic delay. Uncertainties also arise concerning the length of the postoperative intensive care in unsuccessful cases. In this study the variables which from clinical experience seemed to be of main prognostic importance were related to the outcome in 44 patients with EH. A surgical decision-making table was compiled from these relationships in order to facilitate the decision process related to the diagnosis and therapy of EH.