A COMPARATIVE STUDY OF THE HEMATOMA RESORPTION RATE IN CONSERVATIVE MANAGEMENT OF EXTRADURAL HEMATOMA WITH OR WITHOUT SKULL FRACTURE drprashantupadhyay16@gmail.com

 

A COMPARATIVE STUDY OF THE HEMATOMA RESORPTION RATE IN CONSERVATIVE MANAGEMENT OF EXTRADURAL HEMATOMA WITH OR WITHOUT SKULL FRACTURE

3

India

Oral or Poster

Extradural hematoma (EDH) is a life-threatening consequence of traumatic brain injury (TBI), requiring prompt evaluation and management. While conservative treatment is appropriate for select cases, factors influencing spontaneous hematoma resorption remain poorly defined. An associated skull fracture is hypothesized to alter resorption dynamics through enhanced venous drainage and decompression, but its impact remains controversial.

This prospective, comparative cohort study was conducted at a tertiary care center over 18 months. Ninety-three patients with radiologically confirmed EDH eligible for conservative management were enrolled and divided into two groups: Group A: EDH with skull fracture Group B: EDH without skull fracture Serial non-contrast computed tomography (NCCT) scans were performed on days 1, 3, 10, and 30 post-injury to assess hematoma volume and thickness. Resorption rate was calculated using the formula: [T(i) – T(d)] / D, where T(i) = initial hematoma volume, T(d) = volume at a given day, and D = day.

Group A demonstrated a significantly faster hematoma resorption rate than Group B (p < 0.05). Although initial GCS scores were lower in Group A, no significant differences were observed in long-term outcomes such as mortality or hospital stay. The accelerated clearance in patients with skull fractures may relate to improved cerebrospinal fluid and venous absorption dynamics at the fracture site.

Skull fractures appear to facilitate faster EDH resorption in conservatively managed patients. These findings may aid in refining patient selection criteria for non-operative management and follow-up protocols. Further multicenter studies are needed to validate these results.