Farooq Azam, Mumtaz Ali, Bilal Khan.
Source of Bleeding in Acute Extra-dural Hematoma.
Pak J Neuro Surg Jan ;17(1):44-6.

Objective: To know about the source of bleeding in acute extra-dural hematoma (EDH) in patients suffering head injury operated in a tertiary care hospital.Materials and Methods: This study was carried out in the Department of Neurosurgery; Govt. Lady Reading Hospital, Peshawar. We retrospectively analyzed the record of patients operated between the December 2012 and June 2013 (six months). Data was entered from the operation notes including the admission number, age, sex, location of the hematoma and presence or absence of fracture, source of bleeding. Data was analyzed using SPSS version 16.Results: A total of 93 patients were operated and three had re-exploration at our department during the six month period and of these 83 were males and 10 were females(male to female ratio; 10:1), fracture was present in 70 (75.3%) patients and the sole cause of bleeding was in patients 49 (52.7%), middle meningeal artery (MMA) was the cause of bleed in 21 (22.6%), both fracture and MMA was the Source of bleed in 14 (15.1%), generalized ooze in 5 (5.4%) and sinus bleed was encountered in 3 (3.2%) while in one patient the source was unidentified (1.1%).Conclusion: The fracture has been associated with the EDH in almost 75% of cases and has been the sole cause of bleed in more than half cases and along with MMA in every fifth case of EDH.

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