Surgical management of acute epidural hematomas.

M. Ross Bullock, Randall Chesnut, Jamshid Ghajar, David Gordon, Roger Hartl, David W. Newell, Franco Servadei, Beverly C. Walters, Jack E. Wilberger

Research output: Contribution to journalArticle

146 Citations (Scopus)

Abstract

INDICATIONS FOR SURGERY: An epidural hematoma (EDH) greater than 30 cm3 should be surgically evacuated regardless of the patient's Glasgow Coma Scale (GCS) score. An EDH less than 30 cm3 and with less than a 15-mm thickness and with less than a 5-mm midline shift (MLS) in patients with a GCS score greater than 8 without focal deficit can be managed nonoperatively with serial computed tomographic (CT) scanning and close neurological observation in a neurosurgical center. TIMING: It is strongly recommended that patients with an acute EDH in coma (GCS score < 9) with anisocoria undergo surgical evacuation as soon as possible. METHODS: There are insufficient data to support one surgical treatment method. However, craniotomy provides a more complete evacuation of the hematoma.

Original languageEnglish (US)
JournalNeurosurgery
Volume58
Issue number3 Suppl
StatePublished - Mar 2006
Externally publishedYes

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Hematoma
Glasgow Coma Scale
Anisocoria
Craniotomy
Coma
Observation
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Bullock, M. R., Chesnut, R., Ghajar, J., Gordon, D., Hartl, R., Newell, D. W., ... Wilberger, J. E. (2006). Surgical management of acute epidural hematomas. Neurosurgery, 58(3 Suppl).

Surgical management of acute epidural hematomas. / Bullock, M. Ross; Chesnut, Randall; Ghajar, Jamshid; Gordon, David; Hartl, Roger; Newell, David W.; Servadei, Franco; Walters, Beverly C.; Wilberger, Jack E.

In: Neurosurgery, Vol. 58, No. 3 Suppl, 03.2006.

Research output: Contribution to journalArticle

Bullock, MR, Chesnut, R, Ghajar, J, Gordon, D, Hartl, R, Newell, DW, Servadei, F, Walters, BC & Wilberger, JE 2006, 'Surgical management of acute epidural hematomas.', Neurosurgery, vol. 58, no. 3 Suppl.
Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW et al. Surgical management of acute epidural hematomas. Neurosurgery. 2006 Mar;58(3 Suppl).
Bullock, M. Ross ; Chesnut, Randall ; Ghajar, Jamshid ; Gordon, David ; Hartl, Roger ; Newell, David W. ; Servadei, Franco ; Walters, Beverly C. ; Wilberger, Jack E. / Surgical management of acute epidural hematomas. In: Neurosurgery. 2006 ; Vol. 58, No. 3 Suppl.
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