Metabolic and clinical markers of prognosis in the era of CT imaging in children with acute epidural hematomas

Ron Ben Abraham, Eli Lahat, Guy Sheinman, Zeev Feldman, Asher Barzilai, Ran Harel, Zohar Barzilay, Gideon Paret*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Acute epidural hematoma (AEH), a relatively common complication of head injury in children, persists in bearing high morbidity and mortality. Early establishment of prognosis could guide optimal patient allocation, and early identification of predictive signs could assist in choosing appropriate therapeutic interventions. This study aimed to delineate expeditiously obtainable prognostic markers for determining outcome in a subset of children with AEH. We reviewed our 11-year experience with 61 consecutive children <16 years old with head trauma and isolated AEH. Treatment followed a standard advanced trauma life support protocol. A medical history was obtained, and all patients underwent neurosurgical and physical evaluations. CT scans were performed, as were laboratory tests which included arterial blood gases, glucose, electrolytes (K+, Na+), hemoglobin and coagulation studies. Evaluation of the data collected on cause of injury, interval between trauma occurrence and presentation, clinical symptoms, Glasgow Coma Scale (GCS) scores, vital signs, laboratory test results, physical findings and surgical versus conservative management revealed that the best single predictors of outcome following AEH were the GCS and focal neurological deficits. Of all laboratory data obtained on admission, the blood potassium, pH and glucose test results correlated significantly with prognosis. Prognosis can be adequately and expeditiously estimated by selected markers within a comprehensive evaluation of children with AEH. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish
Pages (from-to)70-75
Number of pages6
JournalPediatric Neurosurgery
Volume33
Issue number2
DOIs
StatePublished - 2000
Externally publishedYes

Keywords

  • Epidural hematoma prognosis
  • Head trauma

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