NONOPERATIVE TREATMENT OF ACUTE EXTRADURAL HEMATOMAS - ANALYSIS OF 80CASES

Between 1986 and 1994, 270 patients with an acute extradural hematoma (EDH) were treated in the Department of Neurosurgery, Izmir State Hosp ital in Izmir, Turkey. Eighty patients with a supratentorial EDH of le ss than 30 mL in volume were treated conservatively. The 69 male and 1 1 female patients ranged in age from 5 to 68 years. Five of the patien ts subsequently underwent surgery because of the deterioration in the level of consciousness and enlargement of EDH. One patient died after the operation. EDHs were localized in the temporal region in all five patients who subsequently required the surgical intervention. It has b een emphasized that the findings on a computed tomographic (CT) scan p erformed very early may be misleading in patients with an EDH in progr ess. We concluded that the temporal location of EDHs with heterogeneou s density in patients whose CT scan was performed less than 6 hours af ter trauma had a higher risk of hematoma growth and thus should be tre ated surgically. Periodic CT scans should be performed at brief interv als during the early phase of hospitalization.