Sharafat Seema, Azam Farooq, Khan Zahid
Seema Sharafat, FCPS., Department of Neurosurgery, Medical and Teaching Institute, Lady Reading Hospital, Peshawar, Pakistan.
Farooq Azam, FCPS, Department of Neurosurgery, Medical and Teaching Institute, Lady Reading Hospital, Peshawar, Pakistan.
Pak J Med Sci. 2023 Jan-Feb;39(1):253-256. doi: 10.12669/pjms.39.1.6408.
Through this study, we sought to evaluate the management of posterior fossa extradural hematoma (PFEDH).
An observational study was conducted at the Neurosurgery Department of Lady Reading Hospital in Peshawar from January 2015 to December 2020. All patients who had a traumatic acute extradural hematoma (EDH) of the posterior fossa were included, irrespective of age and gender. The clinical predictors and outcomes were assessed, including the CT-scan findings and Glasgow Coma Scale (GCS) score.
A total of 104 cases with posterior fossa extradural hematoma were identified from 1252 extradural hematoma patients admitted during the study period. The mean age of the enrolled patients was 18.17 ± 14.31 years. Most of the patients were male (65.39%) and belonged to the pediatric age group, i.e., < 15 years (60.6%). CT scan brain was done in all the cases for diagnosis. In 68.3% of cases, an associated occipital bone fracture was observed. Surgery was done in almost 71.2% of cases, and most of the patients experienced good recovery after surgery, as indicated by the GOS score. Linear regression model revealed that treatment (β=-0.20, p=0.038), time duration between surgery and trauma (β=0.43, p=0.000) and GCS category (β=-0.47, p=0.000) were significantly associated with PFEDH outcomes.
In conclusion, PFEDH was frequent among males and the pediatric age group. Serial CT brain is highly recommended in all suspected cases for early diagnosis.
通过本研究，我们旨在评估后颅窝硬膜外血肿（PFEDH）的管理。
于2015年1月至2020年12月在白沙瓦的雷丁夫人医院神经外科进行了一项观察性研究。纳入所有患有后颅窝创伤性急性硬膜外血肿（EDH）的患者，无论年龄和性别。评估临床预测因素和结果，包括CT扫描结果和格拉斯哥昏迷量表（GCS）评分。
在研究期间收治的1252例硬膜外血肿患者中，共确定了104例后颅窝硬膜外血肿病例。入选患者的平均年龄为18.17±14.31岁。大多数患者为男性（65.39%），属于儿童年龄组，即<15岁（60.6%）。所有病例均进行了脑部CT扫描以进行诊断。在68.3%的病例中，观察到伴有枕骨骨折。几乎71.2%的病例进行了手术，如GOS评分所示，大多数患者术后恢复良好。线性回归模型显示，治疗（β=-0.20，p=0.038）、手术与创伤之间的时间间隔（β=0.43，p=0.000）和GCS类别（β=-0.47，p=0.000）与PFEDH结果显著相关。
总之，PFEDH在男性和儿童年龄组中较为常见。强烈建议对所有疑似病例进行连续脑部CT检查以早期诊断。
