TITLE:
Epidemiological Analysis of Surgically Treated Acute Traumatic Epidural Hematoma
AUTHORS:
Aurelien Ndoumbe, Martine Virginie Patience Ekeme, Bonaventure Jemea, Chantal Simeu, Samuel Takongmo
KEYWORDS:
Head Trauma, Epidural Hematoma, Epidemiology, Delayed Surgery, Outcome
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.6 No.3,
June
30,
2016
ABSTRACT: This study is a retrospective analysis of demographic, clinical,
radiological and outcome data of surgically treated acute traumatic epidural
hematomas. Forty-six consecutive cases of epidural hematomas were operated at
the University Hospital Center of Yaoundé, Cameroon, between February 2006 and
December 2013. The mean age was 29.56 years and63.04% of patients were between
21 and 30 years. Almost 94% of patients were males. Thirty-five percent of
patients were motorcycle riders. Road traffic accident was the cause in 70% of
cases. Mean time between head trauma and surgical evacuation was 78 hours. Head
trauma was moderate in 52.17%. Initial loss of consciousness was found in
78.26% and lucid interval in 65.23%. Seventy-four percent of patients had signs
of intracranial hypertension on admission, 35% had at least one neurologic
focal sign and 50% had a scalp wound. Eight patients (17.39%) presented with
unilateral or bilateral mydriasis. On computed tomography, the hematoma was on
the left side in 60.86% of patients and frontal-parietal location was the most
frequent. Computed tomography showed mass effect
in 97.82% of patients. The most frequent surgical procedure was craniotomy. Six
(13.04%) patients died, but 82.60% recovered fully (GOS 5). In Cameroon,
traumatic acute epidural hematoma affects primarily healthy young men in
their twenties and thirties. Road traffic accidents are the main etiology. Most
patients had moderate head trauma and presented with intracranial hypertension.
Early surgery is rarely done. Nevertheless, even with delayed surgery, most
patients have good outcome.