Minimally-invasive aspiration and drainage for management of traumatic epidural hematoma straddling transverse sinus.

ABSTRACT

AIMS: To investigate the therapeutic effect of minimally-invasive aspiration and drainage in traumatic epidural hematoma straddling transverse sinus (TEHSTS). MATERIALS AND METHODS: Fifty-eight patients (39 males and 19 females) with TEHSTS and initial admission Glasgow Coma Scale (GCS) score of 8-10 (mean = 9) were treated with minimally-invasive aspiration and drainage under computed tomography (CT) guidance. Urokinase was used for irrigation and drainage. Post-operatively CT scan was performed at 3 h, 3 days, and 5 days. The volume of hematoma was calculated, and Glasgow outcome scale (GOS) was evaluated 3 months after the operation. RESULTS: The volume of hematoma at 3 h and 3 days post-operation (20 ± 5 ml and 15 ± 2 ml; respectively) were significantly lower than that of pre-operation (45 ± 10 ml; P < 0.05). The hematoma was totally evacuated on 3-5 days post-operation. The GCS was 12 ± 1 on the 5 th day after the operation, which was significantly higher than that of pre-operation (8 ± 1; P < 0.05). Three months after operation, 45 (77%) patients had good recovery (GOS 5) and 9 (15%) patients had moderate disability (GOS 4). CONCLUSIONS: Minimally-invasive aspiration and drainage could be potentially effective in the treatment of TEHSTS with GCS score of equal or greater than 8 points.