Outcome prediction in extradural haematomas.

Extradural haematoma (EDH) is generally a condition of young adult males. It represents only a small percentage of the total number of head injuries admitted to a neurosurgical service, but it must be differentiated from simple concussion, and this means that it is considered in a large number of patients. EDH has the potential for a low mortality rate because of its extraaxial location, but in practice it is approximately 10%. Our results show that about 40% of EDH present with vomiting or nausea and no focal neurological signs. Skull X-ray does not aid in the diagnosis as approximately 35% are reported as being normal. There is a place for conservative treatment of EDH but only if the shift of the midline is minimal (less than 5 mm). A score has been developed to predict accurately a patient's outcome after suffering an EDH. This score includes the Glasgow Coma Scale, pupillary reaction and initial CT scan appearance, and has an accuracy of 88%.