Conservative management of acute epidural hematoma in a pediatric age group.
OBJECTIVE
Craniotomy and evacuation is the standard treatment of acute epidural hematoma (EDH). Here, the authors report their experience in nonoperative management of acute EDH in children with mild head injury.


METHODS
The authors retrospectively reviewed charts of patients with conservatively treated EDH at the Department of Neurosurgery, King Abdulla University Hospital, Irbid, Jordan, between August 2003 and October 2007. All patients had a Glasgow Coma Scale score of 14 or 15, and an initial computerized tomography (CT) scan demonstrating an EDH with or without skull fractures. Follow-up included neurological examination and brain CT.


RESULTS
Six children (3 boys, 3 girls) with acute EDH were successfully managed at our department without surgical intervention. The Glasgow Outcome Scale score of all patients was 5, with no posttraumatic sequelae. Follow-up brain CT showed complete resolution of the EDH within 2-3 months.


CONCLUSIONS
Our results demonstrated that pediatric EDH can be managed nonoperatively. The pronounced increase in the number of CT examinations for patients with head injuries has resulted in a greater proportion of EDH detected in conscious patients. We recommend such treatment be performed in specialized pediatric neurosurgical centers under close neurological observation.
Jamous
Mohammad A
MA
Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. mojamous@yahoo.com
Abdel Aziz
Hani
H
Al Kaisy
Farouk
F
Eloqayli
Haytham
H
Azab
Mohammed
M
Al-Jarrah
Muhammed
M
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D003422:Critical Care / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome