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Journal of Korean Neurosurgical Society 1995;24(11): 1361-1365.
Clinical Experience of Delayed Post-Traumatic Contralateral Epidural Hematoma.
Seung Ho Lee, Whan Eoh, Kyu Ho Lee, Bong Sup Chung
1Department of Neurosurgery, Kang Dong Sacred Heart Hospital, Seoul, Korea.
2Department of Neurosurgery, Capital Armed Forces General Hospital, Seoul, Korea.
3Department of Neurosurgery, Samsung Medical Center, Seoul, Korea.
ABSTRACT
325 patients underwent emergency evacuation of traumatic intracranial hematomas over a 5-year period. Ten(3%) developed delayed contralateral epidural hematomas. These hematomas were not present on initial computed tomography(CT) scan, but repeat CT scan after craniectomy showed sizable hemorrhage. The authors analyzed 10 cases with delayed post-traumatic contralateral epidural hematoma according to their etiology, hematoma types on computerized tomography, initial Glasgow Coma Scale(GCS) & follow up Glasgow Outcome Scale(GOS). 1) Delayed development of post-traumatic contralateral epidural hematoma after evacuation of initial hematoma occurred in 10 of the 325 head injured patients, an incidence rate of 3%. 2) The important factors affecting patients outcome were the initial GCS & the time interval after surgery. 3) Eight patients were found to have a skull fracture at the site of delayed epidural hematoma formation(80%). 4) The results of delayed contralateral epidural hematoma was 50% good, 50% bad and had a mortality rate of 30%.
Key Words: Head injury; Contralateral epidural hematoma; Computerized tomography; Glasgow coma scale; Glasgow outcome scale
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