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Epidural hematomas in children

S A Schutzman1, P D Barnes, M Mantello

  • 1Division of Emergency Medicine, Children's Hospital, Boston, Massachusetts.

Annals of Emergency Medicine
|March 1, 1993
PubMed
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Traumatic epidural hematoma in children can result from minor head injuries and may present in alert individuals. Early diagnosis and management are crucial for favorable outcomes, minimizing long-term neurologic sequelae.

Area of Science:

  • Pediatric Neurosurgery
  • Trauma Care
  • Neurology

Background:

  • Traumatic epidural hematomas (EDH) in children are a significant concern.
  • Understanding their presentation and outcomes is vital for effective management.

Purpose of the Study:

  • To detail the clinical presentation, treatment strategies, and patient outcomes for pediatric traumatic epidural hematoma.
  • To identify factors influencing the prognosis of children with traumatic EDH.

Main Methods:

  • A retrospective chart review was conducted.
  • The study included 53 children diagnosed with traumatic EDH via computed tomography scan between 1980 and 1990.

Main Results:

  • Epidural hematoma occurred after minor falls in 24 of 53 children.

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  • Most children (51/53) presented with symptoms like vomiting, headache, or lethargy.
  • All patients survived; 45 had normal examinations at discharge, with only mild persistent abnormalities in four at follow-up.

    • Conclusions:

    • Pediatric traumatic EDH can arise from mild head trauma and may occur in alert children.
    • Neurologic sequelae were more common with abnormal examinations or depressed mental status at diagnosis.
    • Improved outcomes may be linked to earlier diagnosis via CT scans and a higher incidence of less severe trauma.