Abstract：
In children, epidural hematomas (EDHs) constitute around 2% to 3% of all head traumas. The aim of this study is to compare the manifestation, prognostic factors, and outcome of surgically treated supratentorial with infratentorial EDHs in pediatric patients.
This is a hospital-based single-center, retrospective study of 350 pediatric patients admitted between January 2016 and December 2021. All pediatric patients to 18 years of age with posttraumatic EDHs with or without other intracranial/extracranial injuries who underwent surgical evacuation were included in the study. Posttraumatic EDHs treated conservatively during the hospital stay and any EDH unrelated to head trauma were excluded. Glasgow Outcome Scale (GOS) score was used to assess functional outcomes at discharge. The status of the patients at 3-month follow-up was assessed by using the pediatric version of the Glasgow Outcome Scale-Extended (GOS-E Peds) Score.
Out of 350 patients, 310 had supratentorial EDH and 40 had infratentorial EDH. In supratentorial EDH, the volume of hematoma, mass effect, and the time interval between trauma and surgery correlated with functional outcome (GOS) at discharge. Anisocoria, hypotension, and intradural injury were associated with functional as well as behavioral outcomes (GOS-E Peds) in the supratentorial EDH group. The severity of the injury was correlated with the functional and behavioral outcomes in both groups.
Infratentorial EDH has better clinical outcomes than supratentorial EDH in surgically treated pediatric patients. The most significant and consistent factor influencing the outcome in both groups was the Glasgow Coma Score on admission.
This is a hospital-based single-center, retrospective study of 350 pediatric patients admitted between January 2016 and December 2021. All pediatric patients to 18 years of age with posttraumatic EDHs with or without other intracranial/extracranial injuries who underwent surgical evacuation were included in the study. Posttraumatic EDHs treated conservatively during the hospital stay and any EDH unrelated to head trauma were excluded. Glasgow Outcome Scale (GOS) score was used to assess functional outcomes at discharge. The status of the patients at 3-month follow-up was assessed by using the pediatric version of the Glasgow Outcome Scale-Extended (GOS-E Peds) Score.
Out of 350 patients, 310 had supratentorial EDH and 40 had infratentorial EDH. In supratentorial EDH, the volume of hematoma, mass effect, and the time interval between trauma and surgery correlated with functional outcome (GOS) at discharge. Anisocoria, hypotension, and intradural injury were associated with functional as well as behavioral outcomes (GOS-E Peds) in the supratentorial EDH group. The severity of the injury was correlated with the functional and behavioral outcomes in both groups.
Infratentorial EDH has better clinical outcomes than supratentorial EDH in surgically treated pediatric patients. The most significant and consistent factor influencing the outcome in both groups was the Glasgow Coma Score on admission.
摘要：
目标：在儿童中，硬膜外血肿（EDH）约占所有头部创伤的2-3％。这项研究的目的是比较表现，预后因素，和手术治疗的结果在小儿患者的幕下EDH。
方法：这是一个以医院为基础的单中心，对2016年1月至2021年12月期间收治的350例儿科患者进行回顾性研究.所有创伤后EDH伴或不伴其他颅内/颅外损伤，在18岁以下的儿科患者中接受手术疏散，包括在研究中。住院期间保守治疗创伤后EDH，排除与头部创伤无关的任何EDH。格拉斯哥预后量表（GOS）评分用于评估出院时的功能结局。通过使用格拉斯哥结果扩展量表（GOS-EPeds）评分的儿科版本评估了三个月随访时患者的状态。
结果：在350名患者中，310患有幕上EDH，40患有幕下EDH。在幕上EDH中，血肿的体积,质量效应,创伤和手术之间的时间间隔与出院时的功能结局（GOS）相关。焦虑,低血压,在幕上EDH组中,硬膜内损伤与功能和行为结局(GOS-EPeds)相关。损伤的严重程度与两组的功能和行为结果相关。
结论：在手术治疗的儿科患者中，幕下EDH比幕上EDH具有更好的临床疗效。影响两组结局的最重要和一致的因素是入院时的格拉斯哥昏迷评分（GCS）。
方法：这是一个以医院为基础的单中心，对2016年1月至2021年12月期间收治的350例儿科患者进行回顾性研究.所有创伤后EDH伴或不伴其他颅内/颅外损伤，在18岁以下的儿科患者中接受手术疏散，包括在研究中。住院期间保守治疗创伤后EDH，排除与头部创伤无关的任何EDH。格拉斯哥预后量表（GOS）评分用于评估出院时的功能结局。通过使用格拉斯哥结果扩展量表（GOS-EPeds）评分的儿科版本评估了三个月随访时患者的状态。
结果：在350名患者中，310患有幕上EDH，40患有幕下EDH。在幕上EDH中，血肿的体积,质量效应,创伤和手术之间的时间间隔与出院时的功能结局（GOS）相关。焦虑,低血压,在幕上EDH组中,硬膜内损伤与功能和行为结局(GOS-EPeds)相关。损伤的严重程度与两组的功能和行为结果相关。
结论：在手术治疗的儿科患者中，幕下EDH比幕上EDH具有更好的临床疗效。影响两组结局的最重要和一致的因素是入院时的格拉斯哥昏迷评分（GCS）。
