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 journalReview article

166 Scopus citations

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)
Pages (from-to)S7-15; discussion Si-iv
JournalNeurosurgery
Volume58
Issue number3 Suppl
StatePublished - Mar 2006

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Bullock, M. R., Chesnut, R., Ghajar, J., Gordon, D., Hartl, R., Newell, D. W., Servadei, F., Walters, B. C., & Wilberger, J. E. (2006). Surgical management of acute epidural hematomas. Neurosurgery, 58(3 Suppl), S7-15; discussion Si-iv.