Post‑traumatic bilateral acute extradural hematoma: About three cases treated at Niamey National hospital

Background

Epidural hematoma often develops in a single side in the skull box. However, even though this is quite rare, it may also arise from two sides: the so-called bilateral extradural hematoma (BEDH). Here, we report three cases of BEDH occurring in three young male patients following a head trauma.

Methods

We present three cases of BEDH and relate our experience with its management in general and discuss the relevant literature.

Cases description: The first case is a 15-year old male with no past history, referred to our emergency department for sustained headache, nausea/vomiting following a head trauma due to a wood blow with brief loss of consciousness. The head CT (Computed Tomography) scan performed showed a biparietal extradural hematoma. The 2nd case was a 41-year-old male, with no past history, referred to our emergency department for headache, nausea/vomiting following a head injury due to a wood blow with brief loss of consciousness. The head CT scan showed a double (frontal and parietal) bilateral extradural hematoma. The 3rd case was about a 20-year-old male patient referred to our casualty for sustained loss of consciousness with vomiting following head trauma caused by a machete blow. The head CT scan revealed a biparieto-frontal extradural hematoma. The three patients underwent hematomas evacuation through craniotomy. The post-operative follow-up was uneventful.

Conclusion

Post‑traumatic bilateral acute extradural hematoma remains uncommon. Its management requires careful planning, judicious surgical approach, and time management for good results.