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Vol. 16. Issue 3.
Pages 256-260 (January 2005)
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Vol. 16. Issue 3.
Pages 256-260 (January 2005)
Hematomas epidurales bilaterales simultáneos
Simultaneous bilateral extradural haematoma
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M. Gelabert-González
, M. Iglesias-País, R. Serramito-García, J. Fernández-Villa, A. García-Allut, R. Martínez-Rumbo
Servicio de Neurocirugía. Hospital Clínico Universitario de Santiago. Departamento de Cirugía. Universidad de Santiago de Compostela
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Resumen
Introducción

Los hematomas epidurales constituyen una de las complicaciones más frecuentes de los traumatismos craneales. Los hematomas bilaterales son muy poco frecuentes, se asocian a traumatismos de gran intensidad y se acompañan de una elevada mortalidad.

Objetivos

Analizar los 6 casos de hematoma epidural bilateral (HEB) tratados en los últimos 24 años que representan el 2.5% de todos los hematomas epidurales intervenidos quirúrgicamente en el mismo período de tiempo.

Resultados

La serie esta formada por 5 varones y 1 mujer con una edad media de 32.6 años (rango 16–55). Clínicamente todos presentaban disminución del nivel de consciencia. En 3 pacientes el hematoma sobrepasaba la línea media, y en los otros 3 las localizaciones eran diversas. Se apreció fractura de cráneo en la totalidad de los pacientes. Todos los hematomas fueron tratados quirúrgicamente y la mortalidad operatoria fue del 50%.

Conclusiones

El hematoma epidural bilateral es una entidad clínica poco frecuente y cuyo pronóstico depende fundamentalmente de la situación neurológica preoperatoria.

Palabras clave:
Fractura de cráneo Hematoma epidural bilateral
Tomografía computarizada
Traumatismo craneoencefálico
Abreviaturas:
HE
HEB
GCS
GOS
Summary
Introduction

Epidural haematomas are one of the most common complications of closed head injuries. Bilateral extradural haematomas are rare, usually acute, and generally associated with severe trauma and a high mortality.

Objective

The purpose of this paper is to present six cases of bilateral extradural haematomas seen at our service during the last 24 years and found a incidence of 2.5% of all cases of extradural haematomas surgically treated.

Results

There were 5 males and 1 female with a mean age of 32.6 years (range 16–55). In 3 cases haematoma was across the midline and in the other 3 cases haematomas was found at different locations on cither side. Skull fracture was present in all cases. Surgical approach was the primary treatment in all cases. Mortality in our series was 50%.

Conclusions

Bilateral extradural haematomas is a rare condition and the prognosis is mainly dependent of the pre-operative neurological state.

Key words:
Bilateral epidural haematoma
Head injury
Computed tomography
Skull fracture

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