Epidural haematoma: a study of 71 cases.

A study of 71 patients with epidural haematoma (EDH) who were managed surgically at the Neurosurgical Centre Nijmegen, Netherlands is presented. The male/female ratio was 5:2. 73.2% of all patients were under the age of 40 years. Traffic motor accidents and falls accounted for 84.5% as causes of head injury. 74.6% were either unconscious throughout or were initially conscious and subsequently unconscious. Only 53.7% were initially suspected to have EDH and investigated; while 46.3% developed signs suggestive of haematoma sometime after the initial assessment. The major clinical signs which influenced the initial management policy included lack of verbal response; pupillary dilatation and hemiparesis. Skull fractures were observed in 73.2% of which 9.8% had depressed fractures. The presence of a linear fracture did not influence the initial management policy.