Outcome of Conservatively Managed Supra-Tentorial Extradural Hematoma with and Without Linear Fracture In Pediatric Population

Objective: To compare the outcome of conservatively managed supra-tentorial extradural hematoma in pediatric patients with and without linear fracture Study Design: Comparative cross-sectional study Place and Duration of Study: Neurosurgery Department, Ayub Teaching hospital Abbottabad. September 2020 to May 2022 Methodology: A total 200 children with confirmed diagnosis of supra-tentorial extradural hematoma who were managed conservatively in our neurosurgery unit during the study period were included in the analysis. They were divided into two groups on the basis of presence of linear skull fracture and both the groups were observed closely by clinical team for 48 hours. Increase in size of hematoma, drop in Glasgow coma scale score, critical care unit admission and requirement of surgical excision within 48 hours were the parameters compared in both groups. Results: Out of 200 children included in the study, 127(63.5%) were male while 73(36.5%) were female. Mean age of the study participants was 7.4 6±5.65 years. 138(69%) had linear fracture along with extradural hematoma while 62(31%) had no linear fracture. Statistical analysis revealed that outcome parameters like increase in size of hematoma, drop in Glasgow coma scale score and requirement of surgical excision were found more in patients who had no linear fracture as compared to those who had extradural hematoma and linear fracture (p-value<0.05). Conclusion: Conservative management was seen more successful in patients with linear fracture as compared to those who had no linear fracture along with extradural hematoma in terms of increase in size of hematoma, drop in Glasgow coma ...