Follow-up of children after surgical evacuation of extradural haematomas: Getting it right first time

Ved, Ronak, Bannister, Zoe, Crompton, Jessica, Jesurasa, Anthony, Patel, Chirag and Leach, Paul 2025. Follow-up of children after surgical evacuation of extradural haematomas: Getting it right first time. WFNS Journal 1 , e1-e28. 10.1055/a-2572-6141

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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 was 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 between 5 months - 15 years old. Almost all patients, (33/35; 94.2%) had a Glasgow Outcome Score of five out of five upon hospital discharge. No deaths or recurrences were identified. Thirty patients (86%) received at least one follow-up review post-operatively; 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 GCS were more likely to develop neuropsychological issues (p = 0.045). Discussion: 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, which in this study children remain at risk from, 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.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine
Publisher:	Thieme
ISSN:	2942-2299
Date of First Compliant Deposit:	14 April 2025
Date of Acceptance:	6 March 2025
Last Modified:	14 Apr 2025 09:53
URI:	https://orca.cardiff.ac.uk/id/eprint/177154

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