[Analysis of the causes of failure in the treatment of simple traumatic epidural hematomas].
In the course of 5 years (1983-1987) in the North Bohemian region 88 patients were operated on account of epidural haematoma (EDH). The majority of patients (71%) were treated in a regional hospital. Computed tomography made it possible to divide the group into associated and simple EDH. In the submitted paper the authors discuss only simple EDH, as associated injuries modify the clinical picture. Of 34 simple EDH 85.3% had an atypical course. Alcohol, different localizations of the haematoma or concurrent polytraumatism were the most frequent cause of an atypical course and thus a late diagnosis. These are in the authors' opinion the most frequent causes of failure. Supporting factors were shortcomings in the organization and restricted transport facilities. The finding of an ipsilateral cranial fracture was more typical for the diagnosis of EDH than the presence of the classical triad. The mortality in simple EDH was 26.5% and the morbidity also 26.5%. Only those patients died who were operated in areactive motor unconsciousness--i.e. late.
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Neurochirurgické oddĕlení krajské nemocnice KUNZ, Ustí nad Labem.
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged
Rozbor prícin neúspĕchů v lécbĕ cistého traumatického epidurálního hematomu.