The treatment of "asymptomatic" epidural hematoma

Objective To investigate the indications of non-surgical treatment for the patients whose epidural hematoma were too small to cause clinical symptoms of raised intracranial pressure or focal neuro-dysfunction when admission.Methods 22 patients were included in this retrospective study.To evaluate the relation between prognosis and the following risk factors:the age,sex,Glasgow Coma Scale and initial size of the hematoma,when the CT was given after injury,if a fracture was cross a major vessel or major sinus.Results 71% of patients with a skull fracture across meningeal artery vein or major sinus,the CT given within 6 hours after trauma indicated a surgery treatment,however the factors of age,sex,Glasgow Coma Scale,and initial size of the hematoma were not.Conclusion The patients admitted with small epidural hemaotoma,who have an evidence of a fracture overlaying a major vessel or major sinus,and/or who are diagnosed by CT less than 6 hours after trauma need an intensive care and indicated to a surgery treatment.