A Rural Area Problem Of Large Epidural Hematoma With Herniation

feda anisah makkiyah, Ayodya Heristyorini

Abstract


The shortage of ICU ward was  one of the problem in rural areas like Bogor Residence, West Java, Indonesia. Untreated EDH can progress to coma and eventually death. Here, we describe three cases that had been delayed a couple  days for an operation and still be able to go home with good outcome. 14 years-old boy came to emergency department with a decrease of consciousness 2 day before.  His GCS was 10 and CT showed large left frontal epidural hematoma with  falcine herniation. The hematoma removal done the next day after admission. The patient went home without neurological deficit. Conclusion. Delay in treatment has been shown to increase the mortality rate especially with large epidural haematoma. But, this young patient  recovered fully after  several days brain herniation.


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References


McKee AC, Daneshvar DH. The neuropathology of traumatic brain injury. Handbook of clinical neurology. 127: Elsevier; 2015. p. 45-66.

Taylor A, Butt W, Rosenfeld J, Shann F, Ditchfield M, Lewis E, et al. A randomized trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension. Child's Nervous System. 2001;17(3):154-62.

Nordström C-H, Reinstrup P, Xu W, Gärdenfors A, Ungerstedt U. Assessment of the lower limit for cerebral perfusion pressure in severe head injuries by bedside monitoring of regional energy metabolism. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2003;98(4):809-14.

Kan EM, Ling E-A, Lu J. Microenvironment changes in mild traumatic brain injury. Brain research bulletin. 2012;87(4-5):359-72.

Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, et al. Surgical management of acute subdural hematomas. Neurosurgery. 2006;58(suppl_3):S2-16-S2-24.

Jamieson K, Yelland J. Extradural hematoma: report of 167 cases. Journal of neurosurgery. 1968;29(1):13-23.

Haselsberger K, Pucher R, Auer L. Prognosis after acute subdural or epidural haemorrhage. Acta neurochirurgica. 1988;90(3-4):111-6.

Teixeira PG, Inaba K, Hadjizacharia P, Brown C, Salim A, Rhee P, et al. Preventable or potentially preventable mortality at a mature trauma center. Journal of Trauma and Acute Care Surgery. 2007;63(6):1338-47.

Sampalis JS, Denis R, Frechette P, Brown R, Fleiszer D, Mulder D. Direct transport to tertiary trauma centers versus transfer from lower level facilities: impact on mortality and morbidity among patients with major trauma. Journal of Trauma and Acute Care Surgery. 1997;43(2):288-96.

Chalfin DB, Trzeciak S, Likourezos A, Baumann BM, Dellinger RP. Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Critical care medicine. 2007;35(6):1477-83.

Mezue WC, Ndubuisi CA, Chikani MC, Achebe DS, Ohaegbulam SC. Traumatic extradural hematoma in Enugu, Nigeria. Nigerian Journal of Surgery. 2012;18(2):80-4.

Ndoumbe A, Ekeme MVP, Jemea B, Simeu C, Takongmo S. Epidemiological Analysis of Surgically Treated Acute Traumatic Epidural Hematoma. Open Journal of Modern Neurosurgery. 2016;6(03):89.

Agamanolis DP. [Available from: http://neuropathology-web.org/chapter4/chapter4aSubduralepidural.html.

Stiver SI, Gean AD, Manley GT. Survival with good outcome after cerebral herniation and Duret hemorrhage caused by traumatic brain injury: Case report. Journal of neurosurgery. 2009;110(6):1242-6.


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Sekretariat SENSORIK :

Ruang Jurnal Lantai 2, Gedung Cipto Mangunkusumo, Fakultas Kedokteran, UPN Veteran Jakarta, Indonesia.

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