IP Indian Journal of Neurosciences 5 (2019) 132–136 Content available at: iponlinejournal.com IP Indian Journal of Neurosciences Journal homepage: www.innovativepublication.com Original Research Article Clinico-radiological correlation with outcome in EDH in paediatric age group -a two year study in a tertiary care hospital Gajbhare Sunil Venkati 1, *, Partha Sarathi Dutta 2 , Pulak Deb 3 , Sumit Deb 3 1 Dept. of Neurosurgery, Vardhman Mahavir Medical College, New Delhi, Delhi, India 2 Dept. of Neurosurgery, NRSMCH, Kolkata, West Bengal, India 3 Dept. of Neurosurgery, Calcutta National Medical College, Kolkata, West Bengal, India ARTICLE INFO Article history: Received 23-07-2019 Accepted 05-08-2019 Available online 06-09-2019 Keywords: Extradural Hematoma (EDH) Paediatric Age Group Traumatic ABSTRACT Introduction: Aim of the study was to assess the correlation between clinico -radiological features with outcome in traumatic extradural hematoma in paediatric age group at a tertiary care hospital in Kolkata. Materials and Methods: Total of 47 cases of traumatic paediatric extradural hematoma were analysed prospectively for the period of two years to find out the clinic-radiological pattern with outcome in study group patients. Results: Maximum number of patients were between 1-5 years (55.32%) and male patients slightly outnumbered female (55.32% male vs 44.68% female). Loss of consciousness was the most common clinical presentation. Pretreatment GCS score was found to be directly related to the speed of recovery and outcome. Those in whom there were other associated intracranial injuries showed relatively poor recovery. No sex difference was seen in outcome. Location and volume of EDH did not seem to influence the outcome. Conclusion: Traumatic extradural hematoma in children is an uncommon trauma sequel. Most commonly EDH in children is due to fall from height and Road traffic accident. Classical presentation with lucid interval is uncommon and has no direct effect on outcome. Associated intracranial injuries are common and affect outcome. EDH volume itself does not affect the outcome if timely intervention is done. GCS score at presentation is the most important factor determining the outcome. © 2019 Published by Innovative Publication. 1. Introduction Extradural hematoma is seen in 1-2% cases of head injury patients. The maximum incidence is between the age of 11 to 60 years. Uncommon in young and old age in whom dura is attached to the bone firmly. It is usually a result of direct trauma and is commonly associated with overlying skull fracture though it may develop without skull fracture which is usually seen in children due to increased elasticity of bone in them. 1,2 Extradural hematoma is infrequent in paediatric age group (less than 18 years) and is present in about 1-3% of all paediatric head injuries. It occurs rarely in neonates and is associated with delivery by forceps or vacuum extraction 2 and fall. In infancy and the intermediate childhood period, low velocity impact (such * Corresponding author. E-mail address: drsunil3gmc@gmail.com (G. Sunil Venkati). as falls) comprise the most common mechanism of injury. Even falls from less than few feet may rarely result in EDH in this age group. Although intentional head injury in young children and infants typically causes subdural hematomas, child abuse accounts for 6-18% of EDH in some case series. In late childhood and early adolescent years, road traffic accidents are the primary cause of EDH. 3,4 Though the most common source of EDH is middle meningeal artery rupture, it may also be caused by bleeding from veins, diploic vessels and dural sinuses. Posterior fossa extra dural heamatoma is of venous origin in 85% of the cases and develops as a result of injury to the transverse or sigmoid sinuses, secondary to occipital bone fracture. This study is undertaken because age itself, even within the paediatric age range, is a major independent factor affecting the mortality rate in head-injured patients having EDH. https://doi.org/10.18231/j.ijn.2019.020 2581-8236/© 2019 Published by Innovative Publication. 132