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How serious is a head injury with small epidural hematoma?

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Neurologist, Surgical
Practicing since : 1996
Answered : 138 Questions
My daughter is 4 months and 20 days old. Yesterday she fell from the bed of around 3 feet height at 9.30 a.m, she cried for 10 minuts then she became normal but we found little swelling on left side just above ear on head. We rushed to hospital, at around 1 p.m they did CT scan and found the following. 1) Undisplaced fracture is noted in the left parietal bone. 2) Thin extradural hemorrhage ~ 1-2 mm is noted in the left parietal region. 3) scalp swelling noted in the left parietal region. 4) Cerebal parenchyma appears normal with normal grey-white differentiation. 5) There is no evidence of space occupying lesion. 6) Bilateral lateral, third Ventricles appear normal. 7) No evidence of midline shift. 8) Brain stem and cerebellum appear normal.Fourth ventricle appears normal. 9) Fluid/ Hemorrhage noted in the left mastoid air cells 10) Visualised portion of the paranasal sinuses and orbits appear normal. These are the findings from CT scan. Till 7 p.m we were in hospital for observation the they discharged us saying that since there are no abnormal sympotms she requires only observation, if any symtoms occur we have to take her to the hospital. Now till 11.30 a.m today after 26 hours she looks normal except that she is not turning her head on the left side otherwise normal feeding, no vomiting, nothing abormal seen since fall. My question is how much worrysome is this injury, Is this need any kind of treatment or will it heal at its own. How long we have to keep watch for symptoms imean when will she be safty zone ?
Posted Sun, 9 Feb 2014 in Head Injuries
Answered by Dr. Praveen K Nath 26 hours later
Brief Answer: head injury small EDH needs observation 4/5 days Detailed Answer: Dear Mr XXXXXXX ji Hello I have gone through your daughter,s medical history & CT SCAN report in detail . In my opinion such type of head injury with SMALL EDH needs to be managed conservatively . For such injuries my advice is that you continue with medications as advised by your doctor ( like ANALGESICS / ANTIBIOTICS /ANTI EMETICS ) . CONTINUE OBSERVATION FOR AT LEAST 4/5 DAYS for symptoms like excessive cry , oversleepiness , refusal to take feeds etc. If any of these symptoms recur , then in my opinion a REPEAT CT SCAN BRAIN should be planned to rule out any increase in size of hematoma/oedema. This type of injury normally heals by itself in about 4/5 days MY BEST WISHES FOR A SPEEDY & COMPLETE RECOVERY Thanx Dr Praveen K Nath Director Deptt. of neurosurgery
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Follow-up: How serious is a head injury with small epidural hematoma? 2 hours later
thanks for your reply. I would like to know about the undisplaced skull fracture, how that will heal and how much time it takes. and what are all the precautions we must take till that time.
Answered by Dr. Praveen K Nath 2 hours later
Brief Answer: nothing active to be done for undisplaced skull fr Detailed Answer: Dear mr XXXXXXX ji Hello In my opinion no active treatment is needed for UNDISPLACED FRACTURE SKULL . it heals by itself . Time taken for a fracture skull to heal is about 4/6 weeks . Main cause of concern in these type of fractures is intracranial injury (ie injury to brain ) In your baby,s case it is thin EDH ,which needs to be observed . May be with a repeat CT SCAN head if symptoms like vomitings ,excessive cry ,drowsiness etc persist . Thanx Dr XXXXXXX k XXXXXXX
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