Neurologic Outcome Of Traumatic Intracranial Epidural Hematoma After Neurosurgical Intervention at Addis Ababa Burn, Emergency and Trauma (AABET) Hospital

Abstract

Abstract Background: Epidural hematoma (EDH) is one of the most life threatening lesions in patients with cranio-cerebral trauma. Traumatic EDH is a neurosurgical emergency and timely surgical intervention for significant EDH is the gold standard.(1) Objective: the primary aim of this study is to evaluate the short-term outcomes of traumatic epidural hematoma cases post-neurosurgical intervention at Addis Ababa Burn Emergency and Trauma (AaBET) Hospital in Addis Ababa, Ethiopia. Methodology: this research was employed an institutional-based cross-sectional design. The study is focused on patients admitted with epidural hematoma who have undergone neurosurgical intervention and meet the inclusion criteria, in from GC January 1, 2020, to December 31, 2022. Result: Over a 2-year period, a total of seventy patients were managed, comprising 63 males and 7 females, reflecting a male-to-female ratio of 9:1. The mean age of the patients was 41.8 years (±24.9), with the age distribution indicating a concentration of 38.6% of patients in the 29 38 age group. Assault was the leading mechanism of injury (MOI) among studied population, accounting for 61%, followed by motor vehicle accidents (MVA) at 20%, fall from height at 14.3%, and gunshots representing the least common MOI. Our investigation has pinpointed several factors that significantly influence patient outcomes. Specifically, the presence of abnormal pupillary reaction (Anisocoric), a midline shift exceeding 5 mm, an epidural hematoma (EDH) volume surpassing >30 ml, and ICU admission were all associated with a marked negative impact on patient recovery and overall outcome, with corresponding p-values of 0.015, 0.032, 0.03, and 0.013 respectively. Conclusion: This study revealed good surgical outcome in EDH patients. The key determinant of surgical outcome using GOS in patients with acute EDH is the presence of new focal neurologic deficit, abnormal pupillary reaction, and ICU admission. The duration of injury to surgery showed no net effect on the surgical outcomes of patients. Key words: epidural hematoma, outcome, neurosurgical, intervention