Surgical management of acute epidural hematomas.

Publication Type	Review
Authors	Bullock M, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell D, Servadei F, Walters B, Wilberger J
Journal	Neurosurgery
Volume	58
Issue	3 Suppl
Pagination	S7-15; discussion Si-iv
Date Published	03/01/2006
ISSN	1524-4040
Keywords	Intracranial Hemorrhage, Traumatic, Neurosurgical Procedures
Abstract	INDICATIONS FOR SURGERY: An epidural hematoma (EDH) greater than 30 cm3 should be surgically evacuated regardless of the patient's Glasgow Coma Scale (GCS) score. An EDH less than 30 cm3 and with less than a 15-mm thickness and with less than a 5-mm midline shift (MLS) in patients with a GCS score greater than 8 without focal deficit can be managed nonoperatively with serial computed tomographic (CT) scanning and close neurological observation in a neurosurgical center. TIMING: It is strongly recommended that patients with an acute EDH in coma (GCS score < 9) with anisocoria undergo surgical evacuation as soon as possible. METHODS: There are insufficient data to support one surgical treatment method. However, craniotomy provides a more complete evacuation of the hematoma.
PubMed ID	16710967