Treatment of Acute Epidural Hematoma with Hematoma Volume Greater Than 30 cm³
Clinical Scenario
This protocol addresses acute epidural hematoma confirmed on CT imaging with a hematoma volume exceeding 30 cm³. Crucially, the volume criterion applies regardless of the patient's Glasgow Coma Scale score at presentation.
Why Volume Drives the Decision
When CT confirms an acute epidural hematoma greater than 30 cm³, the hematoma volume itself establishes the clinical indication. The GCS score — whether high or low — does not change the operative course of action in this scenario.
Management Approach
Management centres on a surgical procedure aimed at removing the hematoma. Among the available surgical approaches, the choice of technique has implications for how completely the hematoma can be cleared — the full protocol specifies the recommended approach and the structured regimen.
References
DOI: 10.1227/01.NEU.0000210363.91172.A8
- An epidural hematoma (EDH) greater than 30 cm³ should be surgically evacuated regardless of the patient's Glasgow Coma Scale (GCS) score.
- However, craniotomy provides a more complete evacuation of the hematoma.
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