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Child's Nervous System

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01-12-2020 | Central Nervous System Trauma | Original Article

Role of routine post-operative CT brain following evacuation of extradural haematoma in children: a single-centre experience

Authors: Michael Amoo, Roisin M. O’Cearbhaill, John Caird, Sarah Power, Darach Crimmins

Published in: Child's Nervous System | Issue 12/2020

Abstract

Purpose

Extradural haematoma (EDH) is a serious neurosurgical emergency in children, which confers significant morbidity and mortality rates. The objective of this study was to retrospectively evaluate the role of post-operative imaging in children with EDH who were managed surgically in a national paediatric neurosurgical unit over a 9-year period (January 2008 to December 2016).

Methods

A retrospective case review of paediatric patients who underwent surgical evacuation of extradural haematoma between January 2008 and December 2016 was performed. This included demographic and clinical details, indications for post-operative imaging and outcomes.

Results

Seventy patients underwent surgical management of EDH during this time period, with a male preponderance (69%) and a mean age of 8 years. The commonest location of haematoma in this cohort was in the parietal region (n = 24), with a mean maximum thickness of 25.9 mm and mean volume of 57 ml. Post-operative imaging was performed in 84% of patients. However, only one patient had a change in the course of their post-operative management as a result of post-operative imaging findings.

Conclusions

Post-operative imaging in asymptomatic paediatric patients after evacuation of EDH could therefore be avoided as a routine investigation.

Bejjani GK, Donahue DJ, Rusin J, Broemeling LD (1996) Radiological and clinical criteria for the management of epidural hematomas in children. Pediatr Neurosurg 25:302–308. https://doi.org/10.1159/000121144CrossRefPubMed

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 58:S7–S15 discussion Si-ivPubMed

Champagne PO, He KX, Mercier C, Weil AG, Crevier L (2017) Conservative management of large traumatic supratentorial epidural hematoma in the pediatric population. Pediatr Neurosurg 52:168–172. https://doi.org/10.1159/000455925CrossRefPubMed

Duthie G, Reaper J, Tyagi A, Crimmins D, Chumas P (2009) Extradural haematomas in children: a 10-year review. Br J Neurosurg 23:596–600. https://doi.org/10.3109/02688690902978157CrossRefPubMed

Faheem M, Jaiswal M, Ojha BK, Chandra A, Singh SK, Srivastava C (2019) Traumatic pediatric extradural hematoma: an institutional study of 228 patients in tertiary care center. Pediatr Neurosurg 54:237–244. https://doi.org/10.1159/000501043CrossRefPubMed

Flaherty BF, Moore HE, Riva-Cambrin J, Bratton SL (2017) Pediatric patients with traumatic epidural hematoma at low risk for deterioration and need for surgical treatment. J Pediatr Surg 52:334–339. https://doi.org/10.1016/j.jpedsurg.2016.09.005CrossRefPubMed

Flaherty BF, Moore HE, Riva-Cambrin J, Bratton SL (2018) Repeat head CT for expectant management of traumatic epidural hematoma. Pediatrics 142:e20180385. https://doi.org/10.1542/peds.2018-0385CrossRefPubMed

Kandregula S, Sadashiva N, Konar S, Rao KN, Shukla D, Bhat D, Devi BI (2019) Surgical management of traumatic extradural hematomas in children: an analysis of 201 patients at a tertiary neurosurgical center. Childs Nerv Syst 35:807–813. https://doi.org/10.1007/s00381-019-04088-1CrossRefPubMed

Sheppard JP, Nguyen T, Alkhalid Y, Beckett JS, Salamon N, Yang I (2018) Risk of brain tumor induction from pediatric head CT procedures: a systematic literature review. Brain Tumor Res Treat 6:1–7. https://doi.org/10.14791/btrt.2018.6.e4CrossRefPubMedPubMedCentral

10.

Zhong W, Sima X, Huang S, Chen H, Cai B, Sun H, Hu Y, Liu Y, You C (2013) Traumatic extradural hematoma in childhood. Childs Nerv Syst 29:635–641. https://doi.org/10.1007/s00381-012-1971-xCrossRefPubMed

Title: Role of routine post-operative CT brain following evacuation of extradural haematoma in children: a single-centre experience
Authors: Michael Amoo
Roisin M. O’Cearbhaill
John Caird
Sarah Power
Darach Crimmins
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Central Nervous System Trauma
Computed Tomography
Computed Tomography
Pediatric Neurosurgery
Published in: Child's Nervous System / Issue 12/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-020-04664-w

At a glance: The STEP trials

Springer Medicine

Role of routine post-operative CT brain following evacuation of extradural haematoma in children: a single-centre experience

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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