CT scan showed epidural hematoma, no headache, no surgery. Want second opinion.

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Posted on Sun, 24 Jun 2012 in Brain and Spine
Question: Hi ...

My Dad met with an accident and resulted in brain injury.
Results from CT scan revealed epidural hematoma. But his brain is working normally - no headaches, no seizures and everything looks normal.
The dimensions of the EDH from a Seimens Sensation 64 slice are as follows:
On the day of accident - 1.7 x 0.3 cm
3 days after accident - 1.1 x 0.3cm

But doctors in my city (accident happened in India) said he needs no surgery and just needs some rest - he was given some phenytoin tablets and nothing else!

what do the experts here think about his case.

Please help me understand what are the complexities and Let me know if you need any more details.


I am very curios and tensed here (I stay aways from him) and to get some second opinion in this forum.
doctor
Answered by Dr. Praveen K Nath 7 hours later
Dear Sir,

Hello and my best wishes to you and your father.

I have gone through your father’s reports (CT – Computerized Tomography scan) in detail.
Your dad is having a small sized extradural hematoma (EDH) which is resolving on second CT scan dated 09/01/2012.

As per CT scan reports no active neurosurgical intervention is required.

My advice is to continue with tablet eptoin as advised by your doctor. Get a repeat CT scan head to see complete resolution of EDH and temporal pneumocephalus.

You can mail CT scan film (digitally) after taking a CD ROM of repeat CT scan head. You may upload the report same way as you have done this time.

Wishing your father a speedy recovery.

Thanks
Dr XXXXXXX k XXXXXXX XXXXXXX consultant neurosurgeon

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Praveen K Nath 11 hours later
Hello Sir,

Thank you for your quick reply.

I have asked my father to obtain a fresh CT scan and I will upload it on coming Sunday.

I have few more questions in the meanwhile:
1. Can there be scenarios in which his EDH can intensify? What symptoms should he observe for and what care should he take to ensure it doesn't intensify.
2. How long would recovery take, given his conditions of diabetes and Blood pressure.

Thanks Once again, for your honest and quick reply.

Thanks, XXXXXXX
doctor
Answered by Dr. Praveen K Nath 21 hours later
Hello.

Thanks for writing back.

Sorry for the unavoidable delay in answering your query, as I was busy doing long surgery.

Yes, EDH (Extradural hemorrhage) can increase at times. But in your dad's case, it is unlikely because the repeat ct scan after 48 hours didn't reveal any increase in EDH size, rather it has reduced in size. Its a good sign, as maximum chances of increase in size are during initial 2-3 days.

Symptoms to be observed are increasing headache, recurrent vomiting, drowsiness/unconsciousness, fits etc.

Complete recovery in EDH may take 2-3 weeks, but in your case it can be earlier as the size of EDH was small. Diabetes and hypertention needs to be managed as per protocol.

I hope this helps to solve your queries. Please accept my answer in case you have no follow up queries.

Wish you good health.

Regards.
Above answer was peer-reviewed by : Dr. Jyoti Patil
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Answered by
Dr.
Dr. Praveen K Nath

Neurologist, Surgical

Practicing since :1996

Answered : 146 Questions

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