[Epidural hematoma in children. Prognostic factors. Analysis of 70 cases].
OBJECTIVE
The aim of this study was to analyze the causes of epidural hematoma in order to know its incidence in craneoencephalic trauma and establish prognostic criteria.


METHODS
A retrospective study of 70 children with the diagnosis of epidural hematoma between 1990 and 1995 were studied. Clinical, radiological, chronologic variables and evolution were analyzed.


RESULTS
The diagnosis was made during the first 4 years in 63% of the cases. Neurologic impairment was present at admission in only 33% of the patients. Ages ranged between 7 days and 17 years (mean age: 8 years). Of these patients, 82% were admitted to the PICU, 53% were ventilated and 19% needed ICP monitorization. Radiological findings on the first CT were skull fracture (68%) and temporoparietal epidural hematoma (66%), right-sided (63%). Other kinds of lesions were also recorded in the first and subsequent CTs. Three patients died, 63% recovered fully, 10% had serious sequelae and 23% had some degree of neurodisability.


CONCLUSIONS
The following data correlated with death or neurological impairment: Multiple cerebral contusion (p = 0.002), brain edema (p = 0.05), GCS less than 8 on admission (p = 0.002), and shock (p = 0.003). On the other hand, neither surgical drainage volume, age, location of the hematoma, nor ICP values correlated with a poor prognosis.
Palomeque Rico
A
A
UCI Pediátrica, Unidad Integrada de Pediatría, H. Clínic-H.Sant Joan de Déu, Esplugues, Barcelona.
Costa Clará
J M
JM
Cambra Lasaosa
F J
FJ
Luaces Cubells
C
C
Pons Odena
M
M
Martín Rodrigo
J M
JM
D002648:Child; D002675:Child, Preschool; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
Hematoma epidural en niños. Factores pronósticos. Análisis de setenta casos.