Bhavuk Kapoor

Abstract

Introduction: Pediatric ICH peaks in the first year of life especially in neonatal period with hematological abnormalities or structural vascular disorders such as arteriovenous malformations (AVM) or aneurysms. Imaging modality of choice is NCCT head. Urgent surgery when indicated should be performed early. Aims: To evaluate the causes of spontaneous ICH in paediatric patients and reviewing the literature. Materials and Methods: We have discussed the causes of spontaneous ICH in our paediatric patient and we have discussed the management provided to this patient. Conclusions: Taking a detailed history from the parents and the child is important for determining any history of head injury and bleeding episodes. Despite comprehensive evaluation, it may not be possible to determine the cause of ICH in some pediatric cases. Keywords: Paediatric ICH, Spontaneous ICH, Unknown etiology, ICH surgical evacuation

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Abstract

Background: In approximately 2% of all patients with head injuries, Extradural haematoma occurs. Immediate diagnosis and surgical evacuation is usually required. Outcome in patient with EDH can be assessed using Glasgow outcome score (GOS). Five parameters of outcome we have measured in our study are - good recovery, moderate disability, severe disability, vegetative state and death. Matrials and Methods: Assessment of outcome of patient by using Glasgow outcome score (GOS) and assessing the outcome with respect to the initial GCS at admission was done. Results: Most (51.42%) of the patients were in the age group of 16-31 years. RTA was the most common (51.42%) cause for EDH occurrence. Most of the patients (57.14%) had GCS of 13-15 in our study. Majority of the patients (68.57%) had a Glasgow outcome score of 5, indicating a good outcome. 51.42% of patients having a GCS of 13-15 had a good outcome, whereas 11.42% of patients having GCS of 9-12 and 5.71% of patients having GCS of ? 8 had good outcome. Conclusions: EDH is one of the most serious complications in head injury. It requires immediate diagnosis and management. Urgent surgical intervention improves the outcome Mild head injury patients (GCS 13-15) have good outcome (GOS 5) as compared to with severe head injury (GCS ? 8) patients. Lower GCS patients have poor outcome. Keywords: Extradural hematoma, Glasgow coma scale, Glasgow outcome score, Outcome

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