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Association of Paediatric Surgeons of Bangladesh
Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 1 No. 2 (2010)

Operative Outcome of Acute Extradural Haematoma, Operated at Different Time Interval and Review of International Guidelines

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : July 2010
CONTENTSVolume 01Number 2July 2010
Editorial
‘Constipation in Children’ – Think Twice Before Starting Treatment
Md. Kabirul Islam
86
Review Articles
Vaccination in Pregnancy
Shamim Fatema Nargis, Md. Shahinur Rahman
158
Original Articles
Operative Outcome of Acute Extradural Haematoma, Operated at Different Time Interval and Review of International Guidelines
MM Ehsanul Haque, S Sultana, SU Ahamed, Md. Abdullah Alamgir
88
Single Stage Correction of Rectovestibular Fistula
Kaniz Hasina, Abdul Hanif, S. M. Shafiqul Alam, Shahin Reza, Nazrul Islam, A. K. M. Mizanur Rahman, S. M. Shamsul Huda, M.M. Masud Pervez, Susankar Kumar Mondal, Shahnoor Islam
99
Bronchogenic Cyst
Mirza Kamrul Zahid, Anwarul Anam Kibria, AKM Razzaque, Md. Shamsul Alam, Shahinur Rahman, Kazi Saiful Islam
106
Comparison Between One Stage Correction of Vestibular Fistula by Transfistula Anorectoplasty (TFARP) and Anterior Sagittal Anorectoplasty (ASARP)
Jaglul Gaffer Khan, Mohammad Kabirul Islam, M. A. Rahaman, Jamila Akter, Kaniz Hasina, Susankar Kumar Mondal, Md. Ansar Ali
111
Correlation Between FNAC and Open Biopsy in Cervical Lymphadenopathy in Children
Tahmina Hossain, Md. Ruhul Amin, MTH Siddiqui, Md. Ashraf Ul Huq, Md. Matiur Rahman
118
Lubrication of Meatus and Circumcision Site for Prevention of Post-circumcision Meatal Stenosis in Children Younger Than Two Years Old
Susankar Kumar Mondal, Kaniz Hasina, Md. Ashraf Ul Huq, Md. Ansar Ali, Md. Mahbub-Ul Alam, Muhammed Moinul Hoque, Jaglul Gaffer Khan, A K M Mizanur Rahman, Shahnoor Islam
127
Postnatal Management of Prenatal Obstructive Hydronephrosis
Mugahid Al-Hassan, Paddy Dewan, Padma Rao
132
Study of Voiding Obstruction in Physiological Phimosis
Shahnoor Islam, AKM Amirul Morshed, Shafiqul Hoque
137
To Manage Infantile Hypertrophic Pyloric Stenosis by "Double-Y Pyloromyotomy" is a better Surgical Approach
Md. Ansar Ali, Kaniz Hasina, Shahnoor Islam, Md. Ashraf Ul Huq, Md. Mahbub-Ul Alam, Susankar Kumar Mondal
143
Use of Betel Leaves in Pediatric Stoma Care
Md. Ashraf Ul Huq, A K M Mizanur Rahman, Tahmina Hossain
148
Laparoscopic Repair of Peptic Ulcer Perforation - Our Initial Experience
Md. Saiful Hoque, Gazi Mohammad Zakir Hossain, Nur Hossain Bhuiyan, Md. Rashedul Hasan, Mayin Uddin Mahmud, Alamgir Rashid Chowdhury
153
Case Reports
Bilateral Lumbar Hernia - a Rare Occurrence in Infant
Shahnoor Islam, AKM Amirul Morshed, Md. Ashraf Ul Huq, Md. Mahbub-Ul Alam, Susankar Kumar Mondal, Kaniz Hasina
162
Inflammatory Pseudotumour of Mesentery - A Case Report
Bilal Mirza, Afzal Sheikh
166
The Official Journal of the
ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • MM Ehsanul HaqueDepartment of Neurosurgery, Sher-E-Bangla Medical College & Hospital, Barisal
  • S SultanaDepartment of Ophthalmology, Shahid Sohrawardi Medical College & Hospital, Dhaka
  • SU AhamedDepartment of Neurosurgery, Dhaka Medical College & Hospital, Dhaka
  • Md. Abdullah AlamgirDepartment of Neurosurgery, Dhaka Medical College & Hospital, Dhaka

Keywords

EDH Middle meningeal artery RTA GCS GOS

Abstract

Objective: To determine the prognostic factors of the functional outcome of patients surgically treated for acute extradural haematoma. Methods: Sixty three cases of extradural haematoma was studied over a period of two years from July 2001 to July 2003 in dept of neurosurgery Dhaka Medical college & Hospital. Study was prospective for their clinical profile and operative measures. Clinical characteristics, radiologic findings, and the time intervals with regard to treatment course were investigated to determine the interactions between all these factors and functional outcome. Their clinical presentation varied from intense headache to deep coma and fixed pupil. Patients were divided into two groups on the basis of the GCS level on admission and also on the basis of the operative time interval. All patients were treated surgically and haematoma evacuated. Results: Out of 63 cases 26 cases (41.3%) were in 3rd decade. Male to female ratio was 14:1, where males were 93.6% (59 cases) out of total 63. Most common mode of injury causing EDH was due to RTA 57% followed by assault (26.9%) & fall from height (15.8%). CT scan confirms site of EDH which was more common in temporal region in 26 cases (41.2%) followed by frontal 13 cases (20.6%), parietal 11 cases (17.4%), temporoparietal region 10 cases (15.8%) & occipital region 3 cases (4.76%). The mean interval between injury and operation in two groups were 36 hours & 5 days (Av). Most important finding was the operative outcome where mortality was 30.1%. This mortality was dependent on the GCS level rather than the preoperative time. But the number of patients achieved good recovery (resume normal life GOS 5) was significantly more among them who were treated within 3 days (mean 24.15 hours) than those who were treated within 5.26 days. Conclusion: This study identifies the risk factors involved in the functional outcome of patients who underwent surgical treatment for acute epidural hematomas. Excessive delay occurred in recognizing the condition and in subsequent transfer of patients. Early intervention in traumatic EDH cases should not be delayed. It gives not only the better result but also reduces the number of disabled vegetative person and reduces morbidity and above all reduces social burden, hospital staying and cost.

Journal of Paediatric Surgeons of Bangladesh (2010) Vol. 1 (2): 88–98

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