Conservative Management of Large Traumatic Supratentorial Epidural Hematoma in the Pediatric Population.
OBJECTIVE
Conservative management of traumatic epidural hematomas is being recognized as a safe alternative to surgical treatment in asymptomatic children. There is still debate about the maximal size of epidural hematoma that should be tolerated before deciding for surgery.


METHODS
We report - through a retrospective cohort study from a single institution - a series of 16 conservatively managed traumatic epidural hematomas of more than 15 mm thickness.


RESULTS
14 patients (88%) were successfully treated using conservative management. Two patients required surgery. These 2 patients had the only 2 documented high-velocity injury mechanisms. All patients had a Glasgow Outcome Scale of 5/5 on follow-up.


CONCLUSIONS
Conservative management with close observation is a safe alternative even in this population of voluminous hematomas. Injury velocity may be a contributing factor for failure of conservative management in this population.
Division of Pediatric Neurosurgery, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, QC, Canada.
Pierre-Olivier
PO
Champagne
Kevin Xiaho
KX
He
Claude
C
Mercier
Alexander G
AG
Weil
Louis
L
Crevier
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000072700:Conservative Treatment / Q000379:methods*; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000209:etiology / Q000601:surgery / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
Conservative management; Epidural hematoma; Pediatric population