title: Traumatic extradural hematoma in childhood.
abstract: OBJECTIVE
  This study was undertaken to assess the clinical and radiological characteristics of children with traumatic extradural hematoma (TEDH), and factors affecting the initial neurological status and outcome.
  
  
  METHODS
  Medical records of 269 consecutive children with TEDH from 2005 to 2012 were retrospectively reviewed, factors affecting the initial neurological status and outcomes were explored using univariate and multivariate analysis.
  
  
  RESULTS
  There were 166 boys and 103 girls (average age: 7.0 years). Fall from a height (59 %) was the most common mechanism of head injury. With increasing age, an increase of motor-vehicle accident and assault was noted. Among the children 85.5 % experienced a Glasgow Coma Scale (GCS) of 13-15, 9.7 % with GCS 9-12, and 4.8 % with GCS 3-8. The main clinical manifestations were headache, vomiting and nausea, and conscious disturbance. The main locations were the temporal, temporoparietal, and frontal regions. The 97.4 % saw a favorable outcome, whereas 2.6 % had a poor outcome (overall mortality: 1.1 %).
  
  
  CONCLUSIONS
  Many factors influenced the prognosis; the most important factors affecting prognosis were the initial neurological condition and secondary brain edema, while the initial neurological status were associated with pupillary abnormality, clinical progression, the number and volume of TEDH, and midline shift. Although the outcome was excellent in most cases, early diagnosis and surgical evacuation before irreversible brain damage was important to lower mortality for those massive TEDHs.
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, #37 Guo Xue Xiang, Chengdu 610041 Sichuan Province, People's Republic of China.
authors.forename: Weiying
authors.initials: W
authors.lastname: Zhong
authors.forename: Xiutian
authors.initials: X
authors.lastname: Sima
authors.forename: Siqing
authors.initials: S
authors.lastname: Huang
authors.forename: Haifeng
authors.initials: H
authors.lastname: Chen
authors.forename: Bowen
authors.initials: B
authors.lastname: Cai
authors.forename: Hong
authors.initials: H
authors.lastname: Sun
authors.forename: Yu
authors.initials: Y
authors.lastname: Hu
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.forename: Chao
authors.initials: C
authors.lastname: You
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome