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SURGICAL OUTCOMES OF ACUTE SUPRATENTORIAL EPIDURAL HEMATOMA FOLLOWING TRAUMATIC BRAIN INJURY AT NGHE AN GENERAL FRIENDSHIP HOSPITAL
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Abstract
Background: This study aims to evaluate the surgical outcomes of acute supratentorial EDH at Nghe An General Friendship Hospital from January 2023 to December 2024. Methods: We conducted a retrospective cross-sectional study on 66 patients diagnosed with acute supratentorial EDH who underwent surgical evacuation. Key variables included surgical techniques, intraoperative bleeding source, need for blood transfusion, postoperative complications, length of hospital stay, and neurological outcomes. Glasgow Coma Scale (GCS) scores were compared pre- and postoperatively. Functional outcomes were assessed using the Glasgow Outcome Scale (GOS) at 1 and 3 months, and prognostic factors were analyzed. Results: Craniotomy with bone flap replacement was performed in 81.2% of cases. The bleeding source was most commonly from skull fractures (84.8%). No intraoperative blood transfusion was required in 50% of patients. Mechanical ventilation >48 hours was needed in 34.8%. The most frequent complication was cerebral edema (15.2%). Average hospital stay was 13.9 days, with 63.6% discharged between days 7–14. GCS scores improved significantly from 10.5 preoperatively to 13.9 at discharge (p<0.001). The proportion of patients achieving GOS V was 16.7% at 1 month and 50.0% at 3 months. There was one case of mortality at 3 months (1.5%). Functional recovery significantly improved between 1 and 3 months (p<0.001). Poor neurological recovery at 1 month was significantly associated with initial GCS ≤12, midline shift >10 mm, and prolonged mechanical ventilation (>48h). At 3 months, only low initial GCS remained a significant predictor. Conclusion: Surgical treatment of EDH resulted in favorable neurological recovery with low complication and mortality rates. Initial GCS score was the most significant prognostic factor for long-term functional outcome, underscoring the importance of early surgical intervention before neurological deterioration occurs.
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Keywords
Epidural hematoma; Cranial surgery;Traumatic brain injury.
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