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 were 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 aged between 5 months
and 15 years. Almost all the patients (33/35; 94.2%) had a Glasgow Outcome Score (GOS)
of 5 out of 5 upon hospital discharge. No deaths or recurrences were identified. Thirty
patients (86%) received at least one follow-up review postoperatively; 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
Glasgow Coma Scale (GCS) were more likely to develop neuropsychological issues (p = 0.045).
Conclusion
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. In this study, children remain
at risk 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.
Keywords
paediatric - extradural - haematoma - neuropsychology - follow-up
