Comparison of Surgical versus Conservative Management of Borderline Traumatic Extradural Hematomas Without Neurological Deficit

Objective:  To compare the outcome of surgical versus conservative treatment of traumatic extradural hematoma in the supratentorial regin. Material and Methods:  It was a prospective randomized controlled trial conducted in Departments of Neurosurgery, Allied Hospitals, Faisalabad between December 2019 to November, 2020. A total of 100 patients Supratentorial EDH; fulfilling the selection criteria were enrolled. All patients underwent clinical and radiological assessment of EDH volume by the same neurosurgical team. The patients were then divided randomly into two groups by using the lottery methods. Group A patients were conservatively managed. Group B underwent surgery. All surgeries were done by the same surgical team. Glasgow outcome scale was noted in 5 days after admission or surgery in both groups. Results:  The patients average age was 29.96 years, male to female ratio was 1.7:1. The mean volume of hematoma was 24.68 and 27.56 in group A (conservative group) and Group B (operated group) respectively. The favorable outcome was noted in all the patients and no mortality occurred in any patients. Conclusion:  Both surgical and conservative treatments are equally effective in terms of a favorable outcome and mortality occurrence in management of traumatic EDH <30ml without neurological deficit. The conservative treatment is safe and cost-effective in borderline patients