Association of Outcome of Traumatic Extradural Hematoma with Glasgow Coma Scale and hematoma size

Objective: To find out the correlation between size of traumatic extradural hematoma (EDH), Glasgow coma scale (GCS) and outcome of the patients. Study Design: Descriptive study. Place and Duration of Study: This study was conducted in the department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2004 to January 2005. Materials and Methods: Total patients studied were thirty-eight with EDH diagnosed on CT scan. They were received through emergency. History and examination findings were noted and they were operated in emergency. The correlation between the size of EDH, GCS and Outcome was determined. For data analysis SPSS 12 software was used. Results: There were total thirty-eight patients of traumatic EDH. Among them twelve Patients had temporoparietal EDH, four patients had frontal hematoma, four patients had parietal hematoma, five patients parietooccipetal hematoma, while six patients had temporal hematoma and three patients had frontoparietal hematoma. Among them there were two cases of posterior fossa extradural hematoma and two cases of bilateral EDH. Male to female ratio was 11.7:1. The mean age was 27.6 years. In 4 patients the hematoma size was less than 30 ml. Out of them, one was in GCS 8/15 and 3 patients were in GCS 13 to 15/15. Three patients with extradural hematoma of more than 120ml were in GCS 8 or below. The sizes of hematoma and GCS were correlated. Out of 4 patients with hematoma size less than 30 ml, one had severe disability while remaining had excellent outcome. Three patients of hematoma size of more than 120 ml, one was in vegetative state, one amongst severe disability and one died. There was a good correlation between hematoma size and outcome. Pre- operative GCS had a direct relation with outcome. Out of 9 patients with GCS 3-8/15, two had excellent outcome, two had mild disability, three had severe disability, and one was in vegetative state while one died. Out of 15 patients with GCS 13-15/15, 14 had excellent outcome, one had mild disability while there was no expiry. The outcome correlated with GCS was determined. Conclusion: The outcome of extradural hematoma is affected by GCS and hematoma size. In small hematoma there was a good outcome but in large size hematoma the prognosis is poor. In higher GCS the outcome will be excellent but in low GCS the outcome is poor