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A Journal on Neurosurgery

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Frequency: Bi-Monthly

ISSN 0390-5616

Online ISSN 1827-1855


Journal of Neurosurgical Sciences 1998 June;42(2):95-9


Extradural hemat­o­mas in chil­dren

Maggi G., Aliberti F., Petrone G., Ruggiero C.

Neurosurgical Division, “Santobono” Children’s Hospital, Naples, Italy

Background. Extradural hemat­o­mas ­are ­rare com­pli­ca­tons of ­head ­injures in chil­dren ­often result­ing ­from ­minor ­head trau­mas. Therefore ­the man­age­ment of ­these ordi­nary trau­mas ­remains con­tro­verse ­since in ­many asimp­to­mat­ic cas­es ­the intra­cra­ni­al bleed­ing is detect­ed ­only by CT ­scan.
Methods. During ­the ­study peri­od ­between January 1991 ­and September 1995 six­ty-­one ­patients rang­ing in ­age ­from 5 ­months to 12 ­years ­were oper­at­ed on ­for epi­du­ral hemat­o­mas. They rep­re­sent ­about ­the 3% of ­all ­patients admit­ted ­for ­head inju­ry ­in ­the ­same peri­od in ­our Division. According to ­the ­age, chil­dren ­were divid­ed ­in ­three ­groups (G1, G2, G3). Males pre­dom­i­nate ­over ­females in ­each ­group of ­age. The mech­a­nism of inju­ry, ­the clin­i­cal find­ings, ­the neu­ro­log­i­cal assess­ment on admis­sion, ­the ­site of hemat­o­ma ­and ­the pres­ence of ­skull frac­ture ­were exam­ined in ­order to iden­ti­fy clin­i­cal ­and diag­nos­tic param­e­ters pre­dict­ing devel­op­ing intra­cra­ni­al com­pli­ca­tions.
Results. The ­most com­mon ­cause of ­head trau­ma ­was acci­den­tal ­falls in chil­dren ­under 5 ­years of ­age. Otherwise bicy­cle, pedes­trian ­and ­car acci­dents ­are ­the ­main ­type of inju­ry in old­er ­patients. A ­skull frac­ture ­was iden­ti­fied in 49 cas­es ­with a homo­ge­ne­ous dis­tri­bu­tion ­among ­the ­groups of ­age. Recurrent vom­it­ing ­was ­found in ­about 70% of cas­es. A ­loss of con­sciu­osness ­was fre­quent­ly report­ed (78%) in old­er chil­dren. Outcome main­ly depend­ed on Glasgow or Children Coma Score on admis­sion. In ­our ­series ­the over­all mor­tal­ity ­rate ­was 4.9%.
Conclusions. Our ­data accord­ing ­with ­the lit­er­a­ture sug­gest ­that local­ized ­skull trau­mas, sus­pect­ed frac­tures, a ­loss of con­scius­ness ­after trau­ma ­and recur­rent vom­it­ing ­can be rec­om­mend­ed as indi­ca­tions ­for intra­cra­ni­al com­pli­ca­tions.

language: English


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