Improvement of Headache in Patients after Occipital Extradural Hematoma (EDH) with Less Than 15 ml of Volume after Single Burr Hole Evacuation and Placement of Drain

Objective:  We hypothesized that if we operate occipital extradural hematoma (EDH) having a volume less than 15 ml by single burr hole evacuation of extradural hematoma (EDH) and placement of drain without doing craniotomy then clinical status of the patients particularly headache improves. Method:  An observational study of 15 patients (with presenting GCS: 8–13) was conducted on patients who were operated in Punjab Institute of Neurosciences (PINS). All patients had acute extradural hematoma less than 15 ml after a road traffic accident (RTA). The age range was 22 – 45 years. All patients were operated on within 12 hours of road traffic accident. The timing of surgery was in the range of 1-2 hours. Results:  In all patients, surgery was performed by a single burr hole at the occipital region at the site of occipital EDH and the drain was placed in an extradural position. Co-morbidities in our patients were DM, polytrauma. Receiving GCS was 9 in 2 (13.33%) patients, was 13 in 10 (66.67%), was 8 in 1 (6.66%) patient and receiving GCS was 15 in 2 (13.33%) patients. All patients were assessed clinically on 5th post-operative day. It was seen headache was relieved on 5th post-operative day in all patients except 1 (6.66%) patient. Our 1 (6.66%) patients came for follow-up with the complaint of headache and vomiting which was managed conservatively. Conclusion: Surgery by single burr hole evacuation and placement of drain is a safe method if occipital EDH is less than 15 ml in volum