When conservative treatment is considered, adequate neurological observation is mandatory. This depends on the neurological state of the patient rather than the size of the extradural haematoma. Radiologically significant extradural haematomas can be treated conservatively. They all made a complete recovery and showed resolution of the haematoma on CT scanning. Their condition was either static or improving.
PRINCIPLES OF NEUROSURGERY SETTI RENGACHARY PDF SERIAL
ResultsĪll the 50 patients were managed conservatively, being kept under neurosurgical care and were followed up by serial CT scanning. All the 50 patients had minimal symptoms and signs which were headache and rarely vomiting but no loss of consciousness, and none of the patients had papilloedema. A CT scan was done 24–48 h after the head injury. This study is limited only to the 50 patients who did not require surgery. During the same period, there were another 270 patients who had an extradural haematoma and all of them needed surgical treatment. This was during the last 3 years at Assiut University Hospital. The authors report 50 patients who had an extradural haematoma on computed tomographic scanning and did not need surgical treatment. If this can be shown as a suitable alternative to surgical intervention, it will offer a mode of treatment that has fewer potential complications and risks than the traditional surgical route. With the routine use of computed tomography (CT) for management of head injury patients, non-operative management is being used more often in selected patients (Narayan and Kempisy, Principles of Neurosurgery, 2005 Bricolo and Pasaut, Neurosurgery 14:8-12, 1984 Dubey et al., Neurol India 52:443-445, 2004 Offner et al., Am J Surg 192:801-805, 2006). These patients have traditionally been treated with urgent surgical evacuation of the haematoma to relieve the compression of the brain and brain stem (Bricolo and Pasaut, Neurosurgery 14:8-12, 1984). With the extensive blood supply to the vein, injury to the meningeal arteries leads to rapid intracranial bleeding of significant amounts of blood. Ellenbogen.Extradural haematomas form 0.5% of all head injuries (Narayan and Kempisy, Principles of Neurosurgery, 2005). Xi, 865 pages : illustrations (chiefly color), charts 28 cmĬhapter 1 Landmarks in the History of Neurosurger圜hapter 2Ěpproach to a Patient with Neurological DisorderChapter 3Ěpplications of Principles of Cellular and Molecular Biology in Neurosurgical DisordersChapter 4 Intracranial PressureChapter 5 Impaired ConsciousnessChapter 6 Perioperative Care of the Neurosurgical PatientChapter 7 Spinal DysraphismChapter 8 Hydrocephalus in ChildrenChapter 9 Hydrocephalus in AdultsChapter 10Ğndoscopic Neurosurger圜hapter 11ĜraniosynostosisChapter 12Ĝhiari MalformationsChapter 13Ĝerebrovascular Occlusive DiseaseChapter 14 Intracranial AneurysmsChapter 15 Vascular Malformation Affecting the Nervous SystemChapter 16 Spontaneous Intracerebral HemorrhageChapter 17 Interventional Neuroradiolog圜hapter 18 The Multiply Injured PatientChapter 19Ĝlosed Head Injur圜hapter 20 Gunshot Wounds of the HeadChapter 21 Skull and Facial FracturesChapter 22 Traumatic Intracranial HematomasChapter 23 Injuries to the Cervical SpineChapter 24 Thoracolumbar Spine FracturesChapter 25Ěcute Nerve InjuriesChapter 26Ğntrapment NeuropathiesChapter 27 Management of PainChapter 28ěrain and Spinal AbscessChapter 29 Neuro-oncology: An OverviewChapter 30 GliomasChapter 31 Metastatic Brain TumorsChapter 32 MeningiomasChapter 33 Tumors of the Pineal RegionChapter 34Ĝerebellopontine Angle TumorsChapter 35 Posterior Fossa TumorsChapter 36Ěssessment of Pituitary FunctionChapter 37 Non-functions Pituitary AdenomasChapter 38ğunctioning Pituitary TumorsChapter 39ĜraniopharyngiomasChapter 40 Tumors & Cysts of the Third VentricleChapter 41 Metastatic Tumors of the SpineChapter 42 Spinal Intradural Extramedullary TumorsChapter 43 Intramedullary Tumors and Tumors of the Cauda EquinaChapter 44 Tumors of the Cranial BaseChapter 45 Radiation Therapy for Cerebral Nervous System TumorsChapter 46 Stereotactic Radiosurger圜hapter 47Ĝhemotherapy of Central Nervous System TumorsChapter 48Ĝervical Disc Disease and SpondylosisChapter 49 Lumbar Disc DiseaseChapter 50 Lumbar Spinal StenosisChapter 51 Trigeminal NeuralgiaChapter 52 Sterotactic Surger圜hapter 53 Medical and Surgical Treatment of EpilepsyĮdited by Setti S.
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