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DOI: 10.1055/a-2572-6141
Follow-up of Children after Surgical Evacuation of Extradural Haematomas: Getting it Right First Time
Abstract
Objective
Surgical outcomes for children with an extradural haematoma (EDH) can be excellent. However, neuropsychological outcomes of children after surgery for EDH are sparsely reported, and follow-up for these children is non-standardised. This study describes the follow-up and neuropsychological outcomes of a cohort of children who had surgery for an EDH.
Methods
Anonymised data were collated from a prospectively collected cohort of paediatric patients who underwent urgent surgery for EDH at a single neurosurgical centre from March 2007 to May 2021.
Results
Thirty-five patients were included in the study. Patients were aged between 5 months and 15 years. Almost all the patients (33/35; 94.2%) had a Glasgow Outcome Score (GOS) of 5 out of 5 upon hospital discharge. No deaths or recurrences were identified. Thirty patients (86%) received at least one follow-up review postoperatively; five patients (14%) had no documented follow-up. Forty percent (12/30) of patients who were followed up had neuropsychological concerns identified. Of these children, only four (33%) received formal neuropsychological review and treatment. Children with a low-presentation Glasgow Coma Scale (GCS) were more likely to develop neuropsychological issues (p = 0.045).
Conclusion
Children with EDHs can have good surgical outcomes. However, follow-up for these patients can be variable, which may be suboptimal for identifying the neuropsychological issues which can develop in children following head injury. In this study, children remain at risk even when the blood location is extra-axial, as in cases of EDH. All children should, therefore, receive formal follow-up and neuropsychological review after surgery for EDH.
Ethical Approval Statement
This study was performed in line with the principles stated in the Declaration of Helsinki and the approval for the retrospective study was granted by the local South Wales Neuroscience Research and Audit Ethics Committee.
Publication History
Received: 30 September 2024
Accepted: 06 March 2025
Accepted Manuscript online:
03 April 2025
Article published online:
06 May 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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