Cervical spine traumatic epidural haematomas

Incidence and characteristics

Lisa Brichko, Birinder Giddey, Jin Tee, Louise Niggemeyer, Mark Fitzgerald

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Objective: Cervical spine traumatic epidural haematomas (CSTEH) can cause potentially devastating neurological deficits if not promptly identified. Study aims were to determine the incidence, characteristics and outcomes for patients with CSTEH. Methods: A retrospective study was performed at a tertiary hospital with an adult Level 1 Trauma Centre on all consecutive patients diagnosed with CSTEH over a 4 year period. Medical record review was undertaken for all patients with the diagnoses of CSTEH to identify patient characteristics including age, mechanism of injury and co-morbid conditions. Additional data was extracted regarding radiology interpretation, surgical interventions, thromboembolic chemoprophylaxis use, discharge disposition and neurological outcomes. Results: A total of 27888 patients were admitted with traumatic injuries between 1 July 2010 and 30 June 2014, of which 1916 patients sustained cervical spine injuries. The incidence of CSTEH was 0.6% among all trauma patients and 9.1% among patients with any cervical spine injury. Of those with CSTEH, 89 patients (50.9%) had neurological deficits consistent with the anatomical location of the epidural haematoma. Magnetic resonance imaging diagnosed CSTEH in 132 patients (75.4%), of whom 23 patients (13.1%) had normal computed tomography cervical spine imaging. Among the patients diagnosed with CSTEH, 13 (7.4%) died and 78 (44.6%) required cervical spine surgical decompressions. Conclusion: This study shows a high incidence of CSTEH among trauma patients. CSTEH is associated with significant morbidity and mortality. High clinical vigilance is required to allow the request and acquisition of urgent magnetic resonance imaging to diagnose CSTEH as the entity is often not evident on initial cervical spine computed tomography investigations.

Original languageEnglish
Pages (from-to)359-365
Number of pages7
JournalEMA - Emergency Medicine Australasia
Volume30
Issue number3
DOIs
Publication statusPublished - Jun 2018

Keywords

  • Cervical vertebrae
  • Diagnostic imaging
  • Epidural, haematoma, spinal
  • Spinal injuries
  • Trauma centres

Cite this

Brichko, Lisa ; Giddey, Birinder ; Tee, Jin ; Niggemeyer, Louise ; Fitzgerald, Mark. / Cervical spine traumatic epidural haematomas : Incidence and characteristics. In: EMA - Emergency Medicine Australasia. 2018 ; Vol. 30, No. 3. pp. 359-365.
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abstract = "Objective: Cervical spine traumatic epidural haematomas (CSTEH) can cause potentially devastating neurological deficits if not promptly identified. Study aims were to determine the incidence, characteristics and outcomes for patients with CSTEH. Methods: A retrospective study was performed at a tertiary hospital with an adult Level 1 Trauma Centre on all consecutive patients diagnosed with CSTEH over a 4 year period. Medical record review was undertaken for all patients with the diagnoses of CSTEH to identify patient characteristics including age, mechanism of injury and co-morbid conditions. Additional data was extracted regarding radiology interpretation, surgical interventions, thromboembolic chemoprophylaxis use, discharge disposition and neurological outcomes. Results: A total of 27888 patients were admitted with traumatic injuries between 1 July 2010 and 30 June 2014, of which 1916 patients sustained cervical spine injuries. The incidence of CSTEH was 0.6{\%} among all trauma patients and 9.1{\%} among patients with any cervical spine injury. Of those with CSTEH, 89 patients (50.9{\%}) had neurological deficits consistent with the anatomical location of the epidural haematoma. Magnetic resonance imaging diagnosed CSTEH in 132 patients (75.4{\%}), of whom 23 patients (13.1{\%}) had normal computed tomography cervical spine imaging. Among the patients diagnosed with CSTEH, 13 (7.4{\%}) died and 78 (44.6{\%}) required cervical spine surgical decompressions. Conclusion: This study shows a high incidence of CSTEH among trauma patients. CSTEH is associated with significant morbidity and mortality. High clinical vigilance is required to allow the request and acquisition of urgent magnetic resonance imaging to diagnose CSTEH as the entity is often not evident on initial cervical spine computed tomography investigations.",
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Cervical spine traumatic epidural haematomas : Incidence and characteristics. / Brichko, Lisa; Giddey, Birinder; Tee, Jin; Niggemeyer, Louise; Fitzgerald, Mark.

In: EMA - Emergency Medicine Australasia, Vol. 30, No. 3, 06.2018, p. 359-365.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Cervical spine traumatic epidural haematomas

T2 - Incidence and characteristics

AU - Brichko, Lisa

AU - Giddey, Birinder

AU - Tee, Jin

AU - Niggemeyer, Louise

AU - Fitzgerald, Mark

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N2 - Objective: Cervical spine traumatic epidural haematomas (CSTEH) can cause potentially devastating neurological deficits if not promptly identified. Study aims were to determine the incidence, characteristics and outcomes for patients with CSTEH. Methods: A retrospective study was performed at a tertiary hospital with an adult Level 1 Trauma Centre on all consecutive patients diagnosed with CSTEH over a 4 year period. Medical record review was undertaken for all patients with the diagnoses of CSTEH to identify patient characteristics including age, mechanism of injury and co-morbid conditions. Additional data was extracted regarding radiology interpretation, surgical interventions, thromboembolic chemoprophylaxis use, discharge disposition and neurological outcomes. Results: A total of 27888 patients were admitted with traumatic injuries between 1 July 2010 and 30 June 2014, of which 1916 patients sustained cervical spine injuries. The incidence of CSTEH was 0.6% among all trauma patients and 9.1% among patients with any cervical spine injury. Of those with CSTEH, 89 patients (50.9%) had neurological deficits consistent with the anatomical location of the epidural haematoma. Magnetic resonance imaging diagnosed CSTEH in 132 patients (75.4%), of whom 23 patients (13.1%) had normal computed tomography cervical spine imaging. Among the patients diagnosed with CSTEH, 13 (7.4%) died and 78 (44.6%) required cervical spine surgical decompressions. Conclusion: This study shows a high incidence of CSTEH among trauma patients. CSTEH is associated with significant morbidity and mortality. High clinical vigilance is required to allow the request and acquisition of urgent magnetic resonance imaging to diagnose CSTEH as the entity is often not evident on initial cervical spine computed tomography investigations.

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KW - Diagnostic imaging

KW - Epidural, haematoma, spinal

KW - Spinal injuries

KW - Trauma centres

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