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

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 journal › Review article › peer-review

261 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 language	English (US)
Pages (from-to)	S7-15; discussion Si-iv
Journal	Neurosurgery
Volume	58
Issue number	3 Suppl
State	Published - Mar 2006
Externally published	Yes

ASJC Scopus subject areas

Surgery
Clinical Neurology

Cite this

@article{4f8aa49844114ca9814d98fab0d4c55b,

title = "Surgical management of acute epidural hematomas.",

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.",

author = "Bullock, {M. Ross} and Randall Chesnut and Jamshid Ghajar and David Gordon and Roger Hartl and Newell, {David W.} and Franco Servadei and Walters, {Beverly C.} and Wilberger, {Jack E.}",

year = "2006",

month = mar,

language = "English (US)",

volume = "58",

pages = "S7--15; discussion Si--iv",

journal = "Neurosurgery",

issn = "0148-396X",

publisher = "Lippincott Williams and Wilkins",

number = "3 Suppl",

}

TY - JOUR

T1 - Surgical management of acute epidural hematomas.

AU - Bullock, M. Ross

AU - Chesnut, Randall

AU - Ghajar, Jamshid

AU - Gordon, David

AU - Hartl, Roger

AU - Newell, David W.

AU - Servadei, Franco

AU - Walters, Beverly C.

AU - Wilberger, Jack E.

PY - 2006/3

Y1 - 2006/3

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=33747161911&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33747161911&partnerID=8YFLogxK

M3 - Review article

C2 - 16710967

AN - SCOPUS:33747161911

SN - 0148-396X

VL - 58

SP - S7-15; discussion Si-iv

JO - Neurosurgery

JF - Neurosurgery

IS - 3 Suppl

ER -

Surgical management of acute epidural hematomas.

Abstract

ASJC Scopus subject areas

Other files and links

Fingerprint

Cite this