title: Epidural hematoma after tympanomastoidectomy and bone-anchored hearing aid (BAHA) placement: case report.
abstract: BACKGROUND
  Epidural hematoma (EDH) has never been reported as a complication after placement of a bone-anchored hearing aid (BAHA). To our knowledge, this is the first case report of an EDH after placement of a BAHA.
  
  
  METHODS
  We report the case of a 15-year-old girl with an EDH after placement of a BAHA. Initially, she presented with a history of right ear conductive hearing loss and had a tympanomastoidectomy and placement of a BAHA at an outpatient surgical facility. Postoperatively, the patient was transferred to the postoperative care unit in stable neurological condition but was subsequently noted to be lethargic with dilated, nonreactive pupils and extensor posturing. A computed tomography scan revealed a large right temporal EDH with midline shift. She was then taken to the operating room emergently for craniotomy and evacuation of the EDH. After evacuation, she was admitted to the pediatric intensive care unit and slowly emerged from her coma with supportive care. She was discharged to inpatient rehabilitation and has made a good recovery.
  
  
  CONCLUSIONS
  This report emphasizes the need for a high index of suspicion of this rare, but life-threatening complication of an EDH after the placement of a BAHA.
authors.affiliation: Division of Neurosurgery, Albany Medical Center, Albany, New York 12208, USA.
authors.forename: Fassil B
authors.initials: FB
authors.lastname: Mesfin
authors.forename: Nora W
authors.initials: NW
authors.lastname: Perkins
authors.forename: Christopher
authors.initials: C
authors.lastname: Brook
authors.forename: David
authors.initials: D
authors.lastname: Foyt
authors.forename: John W
authors.initials: JW
authors.lastname: German
mesh_terms: D000293:Adolescent; D005260:Female; D006310:Hearing Aids / Q000009:adverse effects*; D006407:Hematoma, Epidural, Cranial / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008416:Mastoid / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects*; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000009:adverse effects*