Epidural Hematoma: A Pediatric emergency Managed well

Learn the art of Managing a pediatric emergency through this expert case shared by Dr. Manorama Devi. K. Rajan Enhance your clinical knowledge by learning thorough her rich experience. Follow us for more such Updates!

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I am really thankful to Dr Manorama Devi .K , Rajan for sharing this case of epidural hematoma or more commonly called Extradural Hematoma. Dr Manorama have always taught us a lot of neurology on this forum . I would like to take this opportunity to tell my curofy colleagues- please never think of conservative treatment in EDH - because sometimes at admission EDH in small in size- because scan is taken early - but if you re scan after 24 hours- EDH enlarges - because during this 24 hours period- patient continued bleeding and patient goes in irreversible uncal herniation or mass effect . As middle meningeal artery is ruptured in 75 % of cases in EDH - arterial bleeding is always expands very quickly. In all my posts - I had always emphasized- that a simple burr hole craniotomy which is considered as a minor procedure in neurosurgery should always be done in EDH before serious brain death occurs. As in this case - an important life was saved by timely intervention I still - remember- during my student life - in Bailey and love's surgical text book - a lot was written on lucid interval in EDH Example of a footballer was given - who had an head injury - while playing football and became unconscious- but regained consciousness in 2- 3 minutes and continued to play full football game and wins the game for his side - but dies immediately after the game was over . This was the case of Lucid interval - when he sustained head injury and after cerebral concussion regained consciousness- but the middle meningeal artery continues to bleed till EDH was large enough to cause uncal herniation and death . Thanks Madam - and your comments are welcomed

Thanks Dr Praveen for the illustrative comment.
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Thanks Curofy
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Informative and educative post . Surgery has gone a see changes since our college days we were taught at last drainage of epidural haematoma even anaesthesia for sufficient period was not there as investigations are elusive. Instructions of colonial era compound the surgery. Madam . management by you and team needs congratulation and appreciation. Thanks for sharing and updating .

Thanks Dr Parveen Yograj
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Nice case mam EDH is far more serious than it looks. For this particular case, there was significant edema and midline shift, which required decompression craniotomy otherwise mostly pt started improving on ot table it self with burr hole. Excellent presentation mam Regards

Thanjs DrAnand
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Pediatric epidural hematoma almost exclusively cases by injury to the extent baby falling from bed only one meter height known to occur in case concerned baby.Treatment depends upon surgery or conservative depending on the size in this patient has to be decided on symptoms and size went in davour of surgical intervention as there was midline shift and patient no responsive Ct scan done twice send surgery has to be done due to hematoma and collection of air, patient started improving and within 10 marked recovery Nicely handled case congratulations for hard work timely taken decision I appericiate you work Dr Manorma Devi K, Rajan

Learning case. Well explained.. Thanks for sharing.

Thanks
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NICE ILLUSTRATSTION EPIDURAL HMATOMA IN PAEDIATRIC AGE GROUP IS AN EMERGENCY NEEDS IMMEDIATE INTEVENTION OF NEURO SURGEON AFTER CBT SCAN BRAIN ONE HAS TO ASSESS ALL THE PRAMETERS AND MAY BE AT TIMES BURHOLING MAY BE AN OPTION OF TREATMENT

Very well narrated. Briefly explained including pre and post operate treatment.. Thanks for the beautiful post Dr @Manorama Rajan

Thanks Dr Sunil
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EPIDURAL HEMATOMA VERY. BEAUTIFUL ILLUSTRATION... VERY. USEFUL AND INFORMATIVE UPDATE...

Nice ILLUSTRATSTION EPIDURAL HEMATOMA IN PAEDITRICS IS AN EMERGENCY NEEDS URGENT INTERVENTION OF NEUROSURGOUN M R I MAY NEED BURHOLING AND DRAINAGE OF HEMATOMA

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