Extradural hematoma: analysis of 146 cases.

One hundred forty-six consecutive patients operated on for extradural hematoma (EDH) from 1979 through 1991 were analyzed. This series included patients from both before and after the advent of computed tomography (CT). There were 102 boys and 44 girls, aged 1-16 years. All patients underwent plain skull X-radiography. CT scans were obtained in 72 cases and angiography was performed in 10. Thirty patients with EDH did not have skull fractures. Falls were predominant among the modes of injury. Thirty-seven percent of patients had a lucid interval. The overall mortality was 10%. The mortality rates in the CT and plain X-ray groups were 6% and 16% respectively. There was only one death in patients who did not have a lucid interval. The Glasgow Coma Scale scores of all patients who died in this series were less than 8. We concluded that mydriasis, comatose state at the time of operation, and a lucid interval are ominous signs in the prediction of outcome.