Epidural Hematoma Case Profiles Compatible for Exploratory Burr Hole in dr. Sardjito General Hospital and Affiliated Hospitals

Epidural Hematoma Case Profiles Compatible for Exploratory Burr Hole in dr. Sardjito General Hospital and Affiliated Hospitals

Adiguno Suryo W¹, Rahmat Andi Hartanto²

1. Resident of Neurosurgery, GMU Faculty of Medicine/RSUP Dr Sardjito Yogyakarta

2. Consultant Neurosurgeon, GMU Faculty of Medicine/RSUP Dr Sardjito Yogyakarta

Background

Epidural hematoma (EDH) is considered an emergency because the correlation between response time and patient prognosis is highly significant. A more immediate response results in better prognosis, as the intracranial pressure is rapidly decreased. Burr Hole Exploration is one of the neurosurgical procedures that may be performed by surgeons in areas with minimum supporting facilities or resources.

Method

This is a cross-sectional study with a descriptive study design that was carried out in RSUP dr. Sardjito, Yogyakarta and affiliated hospitals within the period of February 1st 2012 — March 30th 2012. The patients included in this study are those specifically suffering epidural hemorrhage only, with no other intracerebral bleeding sites.

Results

The researchers performing this study obtained 20 EDH cases, 6 (30 %) with presenting GCS of 14-15; 11 (55 %) with presenting GCS of 9-13, and 3 (15 %) with presenting GCS of GCS 6-8. Pupil sizes present consisted of 7 anisochoric cases; 3 among patients with the GCS of 6-8, 3 among those with the GCS of 9-13, and 1 with the GCS of 14-15. Ten (50%) patients suffered from linear head fractures, 1 (5%) suffered a depression head fracture, and 1 (5%) suffered diasthatic fracture.

Distribution of the number of cases corresponding to the region of the hematoma are as follows: 5 frontal, 5 parietal, 1 fronto-parietal, 2 parieto-occipital, 1 temporal, 3 temporoparietal , 1 temporo-frontal and 2 occipital. External lesions were found corresponding to the location of hemorrhage (coup) in 18 patients and not corresponding (countre-coup) in 1 patient. 7 (35%) patients are found to be compatible to undergo Burr Hole Exploratory.

Conclusion

The diagnosis and management of EDH must be done rapidly and thoroughly. 35% of patients in Yogyakarta presenting with signs of herniation are indicated to undergo Burr Hole Exploratory by surgeons with minimum supporting facilities or resources.

Keywords: EDH, Burr Hole Exploratory, Herniation