Epidural hematoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Natural History, Complications, and Prognosis
Natural History
- If left untreated, patients with epidural hematoma may progress to develop permanent paraplegia, loss of sensation, brain herniation, coma and death.[1][2][3][4][5]
Complications
- Common complications of epidural hematoma include:
- Brain herniation[4]
- Death[6]
- Post-traumatic seizures[7]
- Infarction of the brain tissue which may cause:
- Disturbed circulation of the cerebrospinal fluid[9]
- Urinary retention[10]
Prognosis
- Prognosis is generally good in patients treated surgically without delay.[11]
- In patients with acute epidural hematoma the surgery in an interval under two hours leads to 17% mortality rate and 67% of good recoveries but in patients who recover after an interval of more than two hours the mortality rate is 65% and good recovery rate is 13%.[12]
- Overall mortality rate of patients with epidural hematoma is approximately 25%.[12]
- The percentages of overall good recoveries and minimal neurologic deficit in patients with epidural hematoma is approximately 58%.[12]
- The prognosis is worse in older patients and in patients with concomitant injuries of other body regions.[12]
References
- ↑ 1.0 1.1 1.2 Cuenca PJ, Tulley EB, Devita D, Stone A (2004). "Delayed traumatic spinal epidural hematoma with spontaneous resolution of symptoms". J Emerg Med. 27 (1): 37–41. doi:10.1016/j.jemermed.2004.02.008. PMID 15219302.
- ↑ 2.0 2.1 Anipindi S, Ibrahim N (2017). "Epidural Haematoma Causing Paraplegia in a Patient with Ankylosing Spondylitis: A Case Report". Anesth Pain Med. 7 (2): e43873. doi:10.5812/aapm.43873. PMC 5559664. PMID 28824860.
- ↑ 3.0 3.1 Gogarten W, Hoffmann K, Van Aken H (2010). "[Recommendations for the administration of conventional and new antithrombotic agents from the perspective of anesthesiology]". Unfallchirurg. 113 (11): 908–14. doi:10.1007/s00113-010-1881-x. PMID 21069508.
- ↑ 4.0 4.1 Ben-Israel D, Isaacs AM, Morrish W, Gallagher NC (2017). "Acute vertex epidural hematoma". Surg Neurol Int. 8: 219. doi:10.4103/sni.sni_218_17. PMC 5609442. PMID 28966825.
- ↑ 5.0 5.1 Firsching R (2017). "Coma After Acute Head Injury". Dtsch Arztebl Int. 114 (18): 313–320. doi:10.3238/arztebl.2017.0313. PMC 5465842. PMID 28587706.
- ↑ Chakraborty S, Dey PK, Chatterjee S (2015). "Cranial epidural hematoma related to an accidental fall from mother's lap in a neonate". J Pediatr Neurosci. 10 (1): 82–3. doi:10.4103/1817-1745.154370. PMC 4395959. PMID 25878757.
- ↑ Lee ST, Lui TN (1992). "Early seizures after mild closed head injury". J Neurosurg. 76 (3): 435–9. doi:10.3171/jns.1992.76.3.0435. PMID 1738023.
- ↑ Ulrich PT, Fuessler H, Januschek E (2008). "Acute epidural hematoma with infarction of the right hemisphere in a 5-month-old child: case report with a long-term follow-up and a review of the literature". J Child Neurol. 23 (9): 1066–9. doi:10.1177/0883073808315411. PMID 18827272.
- ↑ Fuchs EC, Müller-Busch C, Amtenbrink V (1975). "[Prognosis and long-term prognosis of epidural haematoma (a study of 83 patients) (author's transl)]". Rehabilitation (Stuttg). 14 (2): 82–7. PMID 1233608.
- ↑ Sakakibara R, Yamazaki M, Mannouji C, Yamaguchi C, Uchiyama T, Ito T; et al. (2008). "Urinary retention without tetraparesis as a sequel to spontaneous spinal epidural hematoma". Intern Med. 47 (7): 655–7. PMID 18379155.
- ↑ Jung SW, Kim DW (2012). "Our experience with surgically treated epidural hematomas in children". J Korean Neurosurg Soc. 51 (4): 215–8. doi:10.3340/jkns.2012.51.4.215. PMC 3377878. PMID 22737301.
- ↑ 12.0 12.1 12.2 12.3 Haselsberger K, Pucher R, Auer LM (1988). "Prognosis after acute subdural or epidural haemorrhage". Acta Neurochir (Wien). 90 (3–4): 111–6. PMID 3354356.