Epidural hematoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Indications

  • Surgical intervention is not recommended for the management of [disease name].

OR

  • Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
    • [Indication 1]
    • [Indication 2]
    • [Indication 3]
  • The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
    • [Indication 1]
    • [Indication 2]
    • [Indication 3]

Surgery

  • The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

  • Surgery is the mainstay of treatment for epidural hematoma.[1][2][3]
  • An epidural hematoma greater than 30 cm3 should be surgically evacuated regardless of the patient's Glasgow Coma Scale (GCS) score. An epidural hematoma less than 30 cm3 and with less than a 15-mm thickness and with less than a 5-mm midline shift in patients with a GCS score greater than 8 without focal deficit can be managed nonoperatively with serial computed tomographic scanning and close neurological observation in a neurosurgical center.[4]
  • Acute epidural hematoma with a small amount of bleeding(less than 50 mL)may be treated by minimal invasive surgery methods which avoids craniotomy.[5]

Contraindications

References

  1. Khan MB, Riaz M, Javed G, Hashmi FA, Sanaullah M, Ahmed SI (2013). "Surgical management of traumatic extra dural hematoma in children: Experiences and analysis from 24 consecutively treated patients in a developing country". Surg Neurol Int. 4: 103. doi:10.4103/2152-7806.116425. PMC 3766325. PMID 24032078.
  2. Habibi Z, Meybodi AT, Haji Mirsadeghi SM, Miri SM (2012). "Burr-hole drainage for the treatment of acute epidural hematoma in coagulopathic patients: a report of eight cases". J Neurotrauma. 29 (11): 2103–7. doi:10.1089/neu.2010.1742. PMID 22216933.
  3. Korinth M, Weinzierl M, Gilsbach JM (2002). "[Treatment options in traumatic epidural hematomas]". Unfallchirurg. 105 (3): 224–30. PMID 11995217.
  4. Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW; et al. (2006). "Surgical management of acute epidural hematomas". Neurosurgery. 58 (3 Suppl): S7–15, discussion Si-iv. PMID 16710967.
  5. Wang W (2016). "Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series". Biomed Res Int. 2016: 6507350. doi:10.1155/2016/6507350. PMC 4837251. PMID 27144170.

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Overview

Surgery

As with other types of intracranial hematomas, the blood may be aspirated surgically to remove the mass and reduce the pressure it puts on the brain.[1] The hematoma is neurosurgically evacuated through a burr hole or craniotomy. The diagnosis of epidural hematoma requires a patient to be cared for in a facility with a neurosurgeon on call to decompress the hematoma if necessary and stop the bleed by ligating the injured vessel branches.

  1. McCaffrey P. 2001. "The Neuroscience on the Web Series: CMSD 336 Neuropathologies of Language and Cognition." California State University, Chico. Retrieved on February 6, 2007.