Skip to main content

Intracranial epidural haematomas in elderly patients: observations in 14 patients

Acta Neurochirurgica volume 147, pages 1055–1060 (2005)Cite this article

Summary

Backgrounds. Up to now, extra-dural haematomas (EDH) in elderly patients have been known for their poor prognosis and few studies have focused on the particularity of EDH in the elderly. Most clinical studies relating to EDH have generally focused on its occurrence in children and the middle-aged, grouping people of over 50 and 60 years together as the elderly. The purpose of this paper is to present a series of EDH cases in the elderly.

Method. 500 EDH patients (of all ages) were admitted to our Department from January 1990 to December 2003 and this is a retrospective study of 14 of those patients who were aged 70 years and over.

Findings. The study consists of 8 women and 6 men with an average age of 74 years. A high incidence of disease predisposes elderly to falls, which are the most frequent cause of head trauma. The elderly are less likely to manifest signs or symptoms of increased intracranial pressure due to cerebral atrophy, and almost all haematomas occurred in the parietal area. Post-operative results were satisfactory and only one death was recorded.

Conclusion. This study shows that the elderly, presenting EDH after a fall, have a better prognosis than is often feared.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  • AM Alberico JD Ward SC Choi A Marmarou HF Young (1987) ArticleTitleOutcome after severe head injury. Relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. J Neurosurg 67 648–656 Occurrence Handle3668633

    PubMed  Google Scholar 

  • AL Amacher DE Bybee (1987) ArticleTitleToleration of head injury by the elderly. Neurosurgery 20 954–958 Occurrence Handle3614577

    PubMed  Google Scholar 

  • A Bricolo LM Pasut (1984) ArticleTitleExtradural hematoma: toward zero mortality. Neurosurgery 14 8–12 Occurrence Handle6694798

    PubMed  Google Scholar 

  • B Cagetti M Cossu A Pau C Rivano G Voale (1992) ArticleTitleThe outcome from acute subdural and epidural intracranial haematomas in very elderly patients. Br J Neurosurg 6 227–232 Occurrence Handle1632921

    PubMed  Google Scholar 

  • M Caroli M Locatelli R Campanella S Balbi F Martinelli C Arienta (2001) ArticleTitleMulitple intracranial lesions in head injury. Clinical considerations, prognostic factors, management, and results in 95 patients. Surg Neurol 56 82–88 Occurrence Handle10.1016/S0090-3019(01)00540-7 Occurrence Handle11580939

    Article  PubMed  Google Scholar 

  • F Cordobes RD Lobato JJ Rivas MJ Munoz D Chillon JM Portillo E Lamas (1981) ArticleTitleObservations on 82 patients with extradural hematoma. Comparison of results before and after the advent of computerized tomography. J Neurosurg 54 179–186 Occurrence Handle7452331

    PubMed  Google Scholar 

  • JO Espersen OF Petersen (1982) ArticleTitleComputerized tomography (CT) in patients with head injuries. Assessment of outcome based upon initial clinical findings and initial CT scans. Acta Neurochir (Wien) 65 81–91 Occurrence Handle10.1007/BF01405444

    Article  Google Scholar 

  • TA Genneralli GM Spielman TW Langfitt PL Gildenberg T Harrington JA Jane LF Marshall D Miller LH Pitts (1982) ArticleTitleInfluence of the type of intracranial lesion on outcome from severe head injury. A multicenter study using a new classification system. J Neurosurg 56 26–32 Occurrence Handle7054419

    PubMed  Google Scholar 

  • PT Grant JM Henry GW McNaughton (2000) ArticleTitleThe management of elderly blunt trauma victims in Scotland: evidence of ageism? Injury Int J Care Injured 31 519–528

    Google Scholar 

  • R Hooper (1959) ArticleTitleObservations on extradural hematoma. Br J Surg 47 71–87 Occurrence Handle14403008

    PubMed  Google Scholar 

  • M Idei T Shima M Nishida K Yamane C Milhara T Hatayama H Onda K Manabe A Yokota (2004) ArticleTitleSymmetrical bilateral epidural hematoma after head injury in the mid parietooccipital region. Case report. No Shinkei Geka 32 379–382 Occurrence Handle15227846

    PubMed  Google Scholar 

  • R Illingworth H Shawdon (1983) ArticleTitleConservative management of intracranial extradural haematoma presenting late. J Neurol Neurosurg Psychiatry 46 558–560 Occurrence Handle6875589

    PubMed  Google Scholar 

  • KG Jamieson JDN Yelland (1968) ArticleTitleExtradural hematoma. Report of 167 cases. J Neurosurg 29 13–23 Occurrence Handle5302643

    PubMed  Google Scholar 

  • NR Jones CJ Molloy CN Kloeden JB North DA Simpson (1993) ArticleTitleExtradural haematoma: trends in outcome over 35 years. Br J Neurosurg 7 465–471 Occurrence Handle8267885

    PubMed  Google Scholar 

  • P Kannus S Niemi J Parkkari M Palvanen (2001) ArticleTitleEpidemiology of adulthood injuries: a quickly changing injury profile in Finland. J Clin Epidemiology 54 597–602 Occurrence Handle10.1016/S0895-4356(00)00346-2

    Article  Google Scholar 

  • A Karimi-Nejab W Tritz (1984) ArticleTitleSequelae and prognosis of craniocerebral trauma in elderly people. Adv Neurosurg 12 212–215

    Google Scholar 

  • NW Knuckey S Gelbard MH Epstein (1989) ArticleTitleThe management of “asymptomatic” epidural hematomas. A prospective study. J Neurosurg 70 392–396 Occurrence Handle2915245

    PubMed  Google Scholar 

  • EJ Lee YC Hung LC Wang KC Chung HH Chen (1998) ArticleTitleFactors influencing the functional outcome of patients with acute epidural hematomas: analysis of 200 patients undergoing surgery. J Trauma 45 946–952 Occurrence Handle9820707

    PubMed  Google Scholar 

  • PC Liliang YD Tsai CL Liang TC Lee HJ Chen (2002) ArticleTitleChronic subdural haematoma in young and extremely aged adults: a comparative study of two age groups. Injury, Int J Care Injured 33 345–348

    Google Scholar 

  • RD Lobato F Cordobes JJ Rivas M De La Fuente A Montero A Barcena C Perez A Cabrera E Lamas (1983) ArticleTitleOutcome from severe head injury related to the type of intracranial lesion. A computerized tomography study. J Neurosurg 59 762–774 Occurrence Handle6619928

    PubMed  Google Scholar 

  • PT Munro RD Smith TJR Parke (2002) ArticleTitleEffect of patients’ age on management of acute intracranial haematoma: prospective national study. BMJ 325 1001–1005 Occurrence Handle10.1136/bmj.325.7371.1001 Occurrence Handle12411357

    Article  PubMed  Google Scholar 

  • JT Nagurney P Borczuk SH Thomas (1998) ArticleTitleElderly patients with closed head trauma after a fall: mechanisms and outcomes. J Emerg Med 16 709–713 Occurrence Handle10.1016/S0736-4679(98)00083-3 Occurrence Handle9752942

    Article  PubMed  Google Scholar 

  • D Pang JA Horton JM Herron JE Wilberger JK Vries (1983) ArticleTitleNon surgical management of extradural hematomas in children. J Neurosurg 59 958–971 Occurrence Handle6631518

    PubMed  Google Scholar 

  • E Pozzati F Tognetti (1986) ArticleTitleSpontaneous healing of acute extradural hematomas. Study of twenty-two cases. Neurosurgery 18 696–700 Occurrence Handle3736795

    PubMed  Google Scholar 

  • F Reuter J Warncke (1989) ArticleTitleTraumatic intracranial hemorrhages in elderly people. Advances in Neurosurgery 17 43–47

    Google Scholar 

  • JJ Rivas RD Lobato R Sarabia F Cordobes A Cabrera P Gomez (1988) ArticleTitleExtradural hematoma: analysis of factors influencing the courses of 161 patients. Neurosurgery 23 44–51 Occurrence Handle3173664

    PubMed  Google Scholar 

  • F Servadei G Piazza A Seracchioli N Acciarri E Pozzati G Gaist (1988) ArticleTitleExtradural hematomas: an analysis of the changing characteristics of patients admitted from1980 to 1986. Diagnostic and therapeutic implications in 158 cases. Brain Inj 2 87–100 Occurrence Handle3167275

    PubMed  Google Scholar 

  • M Tomida M Muraki K Uemura K Yamasaki (1998) ArticleTitlePost contrast Magnetic resonance imaging to predict progression of traumatic epidural and subdural hematomas in the acute stage. Neurosurgery 43 66–71 Occurrence Handle10.1097/00006123-199807000-00040 Occurrence Handle9657190

    Article  PubMed  Google Scholar 

  • K Wester (1999) ArticleTitleDecompressive surgery for “pure” epidural hematomas: does neurosurgical expertise improve the outcome? Neurosurgery 44 495–502 Occurrence Handle10.1097/00006123-199903000-00034 Occurrence Handle10069586

    Article  PubMed  Google Scholar 

  • M Wintermark GV Melle P Schnyder JP Revelly F Porchet L Regli R Meuli P Maeder R Chiol eacute;ro (2004) ArticleTitleAdmission perfusion CT: prognostic value in patients with severe head trauma. Radiology 232 211–220 Occurrence Handle15220504

    PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Neurosurgery, CHRU Pontchaillou, Rennes, France

    A. Hamlat, A. Mazzon, M. Adn, X. Morandi, L. Riffaud, Y. Guegan & G. Brassier

Authors
  1. A. Hamlat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Mazzon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Adn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. X. Morandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Riffaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y. Guegan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G. Brassier
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hamlat, A., Mazzon, A., Adn, M. et al. Intracranial epidural haematomas in elderly patients: observations in 14 patients. Acta Neurochir (Wien) 147, 1055–1060 (2005). https://doi.org/10.1007/s00701-005-0601-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-005-0601-8

  • Keywords: Intracranial; extra dural haematoma; elderly; pathophysiology; results.