Retrospective Descriptive Study on Non-operative Management of Epidural Haematoma in a Cohort of Patients at the Korle Bu Teaching Hospital

Thomas K Dakurah, Hadi Mohammed Abdullah, Fuseini Adams, Emmanuel BannermanWilliams and Benjamin Abaidoo

Department of Surgery, Neuroscience Unit, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Ghana
Department of Surgery, Neuroscience Unit, Korle Bu Teaching Hospital, Ghana
Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Ghana
Department of Surgery, Ophthalmology Unit, School of Medicine and Dentistry, College of Health Sciences, University of Ghana

^*Correspondance to: Thomas K Dakurah 

 PDF  Full Text DOI: 10.25107/2474-1647.1802

Abstract

Background: Head injury resulting from trauma is the main cause of death in people younger than 45 years. Extradural hematoma is the most serious treatable complication of head injury, requiring immediate diagnosis and surgical intervention.
Objective: To determine whether selected cases of Acute Epidural Haematoma can be managed non-operatively.Methods: This is a retrospective study of acute epidural haematomas managed non-operatively from a cohort of 107 cases at the Korle-Bu Teaching Hospital from 7th November, 2012 to 15th February, 2016. Patients’ demographic and clinical information including case notes and CT scan findings were retrieved and analyzed with IBM SPSS version 20. Total cost of hospital bills including the cost of medication, CT scans and hospitalization of patients managed non-operatively were compared to those managed operatively.Results: A total of 19 cases of EDH were managed conservatively over the study period. There was a male preponderance of 78.95%. The mean age was 30.89 years with mean duration (in days) of hospital stay as 10.42 days. Motor vehicular accident (MVA) was the main mechanism of injury (55.56%). A single mortality was recorded at 3 months post-discharge. The total estimated cost of craniotomy and evacuation of haematoma was 4 times (75% higher) that of non-operative management.Conclusion: It has become increasingly apparent that many small epidural hematomas will resolve with nonsurgical management without neurologic sequelae. This study also showed that nonoperative management of acute epidural haematoma may be cost-effective compared with operative management.

Keywords

Epidural haematoma; Non-operative management; Tempo-parietal; Neurological deficit; Glasgow Coma Scale; Middle income country

Cite the article

Dakurah TK, Abdullah HM, Adams F, Bannerman-Williams E, Abaidoo B. Retrospective Descriptive Study on Non-operative Management of Epidural Haematoma in a Cohort of Patients at the Korle Bu Teaching Hospital. Clin Surg. 2017; 2: 1802.