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Calcified Epidural Hematoma after Conservative Treatment of Acute Epidural Hematoma in the Pediatric Population: A Systematic Review

Title: Calcified Epidural Hematoma after Conservative Treatment of Acute Epidural Hematoma in the Pediatric Population: A Systematic Review
Authors: D’Andrea, Marcello; Mongardi, Lorenzo; Cultrera, Francesco; Fuschillo, Dalila; Peraio, Simone; Roblot, Paul; Musio, Antonio; Tosatto, Luigino; Giordano, Flavio
Source: Pediatric Neurosurgery ; volume 57, issue 6, page 389-395 ; ISSN 1016-2291 1423-0305
Publisher Information: S. Karger AG
Publication Year: 2022
Description: Background: Acute traumatic epidural hematoma (EDH) is a complication in 2–3% of pediatric head injuries. Surgery is mandatory in symptomatic cases; otherwise, conservative treatment is a valid approach, especially in the pediatric population. Ossified epidural hematomas (OEHs) have been reported in the pediatric population as a rare complication of conservative EDH management, although the exact incidence remains unknown. The progressive increase in conservative management may lead to increases in the OEH incidence over the next few years. Our study aimed to systematically review OEH incidence, management strategies, characteristics (thickness, inner/outer calcifications), complication rates, time to surgery after the EDH diagnosis, and clinical outcomes. Summary: A systematic review was conducted in accordance with the PRISMA guidelines. Studies reporting diagnoses and clear descriptions of OEH after EDH in pediatric patients were considered eligible. Sixteen studies, including 18 pediatric patients aged 0–18 years, were included. Head trauma was the most common cause of OEH. Seven (38.8%) OEHs were treated less than 1 month after EDH diagnosis. Surgery was performed in 17 cases (94.44%), while 1 asymptomatic case (5.56%) was managed conservatively. Key Messages: Surgery was the most commonly used treatment for OEH. Data for conservative treatment of OEH are limited. Magnetic resonance imaging or ultrasound within the first 2 months, to check for EDH resolution, may be crucial to rule out complications in pediatric patients.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1159/000527241
Availability: https://doi.org/10.1159/000527241; https://karger.com/pne/article-pdf/57/6/389/4031585/000527241.pdf
Rights: https://karger.com/pages/terms-and-conditions ; https://karger.com/pages/terms-and-conditions
Accession Number: edsbas.C63AA2FB
Database: BASE