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Follow-up of Conservatively Managed Epidural Hematomas:Implications for Timing of Repeat CT AJNR 20:107-113,115, Sullivan,T.P.,et al, 1999 See this aricle in Pubmed Article Abstract Small asymptomatic epidural hematomas (EDHs) are frequently managed nonoperatively with good neurologic outcome. The EDH enlarged in 37 (23%) of the 160 patients during conservative management. Mean enlargement was 7 mm and the mean time to enlargement was 8 hours after injury and 5.3 hours after CT diagnosis. EDH enlargement occurred within 36 hours after injury in all cases. Of the parameters analyzed, only a high Revised Trauma Score correlated significantly with EDH rehemorrhage, suggesting that intubation and chemical paralysis may prevent rehemorrhage through the restriction of head movements and the control of blood pressure. The subgroup of patients with rehemorrhage experienced no difference in neurologic outcome despite a higher rate of clinical deterioration. EDH enlargement occurs frequently but early. Repeat imaging with CT is most appropriate within 36 hours after injury.

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