title: Distinct strategies in the treatment of epidural hematoma in children: clinical considerations.
abstract: BACKGROUND
  Epidural hematoma (EDH) is the most common form of intracranial bleeding following head trauma in pediatric patients. It may develop into a life-threatening pathology, requiring an immediate neurosurgical intervention. However, due to an increasing number of posttrauma CT scans most pediatric EDH patients can be treated conservatively, because of minor dimensions of the clot and the possibility of quick control scanning.
  
  
  OBJECTIVE
  Evaluation of distinct strategies in the treatment of EDH patients in our department between January 2007 and December 2012.
  
  
  RESULTS
  During this period a total number of 221 patients with EDH were enrolled in the study. Seventy-seven of them (35%) underwent surgical procedures. One hundred and forty-four patients (65%) were treated conservatively. The dominating age group among nonsurgical patients was 0-4 years (85 cases, 61% of the nonsurgical group). In most of these cases a small epidural blood collection with inconsiderable dynamics was observed. Twenty-one patients from this age group (20%) were treated operatively. Among older children (5-18 years) surgical treatment was implemented in 56 (49%) cases.
  
  
  CONCLUSIONS
  (1) EDH may be successfully treated conservatively with the use of control CT scans. (2) Smaller blood clots dominate in younger patients. (3) Surgical intervention is required more commonly in older patients.
authors.affiliation: Department of Pediatric Neurosurgery, Bogdanowicz Memorial Hospital for Children, Warsaw, Poland.
authors.forename: Tymon
authors.initials: T
authors.lastname: Skadorwa
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Zygańska
authors.forename: Mikołaj
authors.initials: M
authors.lastname: Eibl
authors.forename: Bogdan
authors.initials: B
authors.lastname: Ciszek
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome