Ossification of Cranial Epidural Hematomas: A Systematic Review of Management Strategies and Presentation of an Illustrative Case

Article Article scientifique Revue de la littérature Ossification of Cranial Epidural Hematomas: A Systematic Review of Management Strategies and Presentation of an Illustrative Case eng 2024-08-22 2024 author Janssen Insa Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland. 948830 author Haemmerli Julien 0000-0001-5998-8541 Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland. 659636 author Bartoli Andréa Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland. 840772 Département des neurosciences cliniques (OTONO) author Joory Melvin Department of Radiodiagnostics and Interventional Radiology, CHUV, Lausanne, Switzerland. author Richards Emily School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom. author Schaller Karl Lothard Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland. 658606 Département des neurosciences cliniques (OTONO) author Nouri Aria Department of Neurosurgery, Hôpitaux Universitaires de Genève, Geneva, Switzerland. 419006 787-799 10.1089/neur.2024.0065 39184176 2689-288X PMC11342046 https://www.liebertpub.com/doi/10.1089/neur.2024.0065 The presence of a calcified or ossified chronic cranial epidural hematoma (EDH) is rare and has been described in only a few case reports in the literature. Consequently, clear treatment strategies remain elusive and may entail conservative and surgical approaches. In this study, we performed a systematic review of reported cases to evaluate the clinical course and treatment options for these patients. A comprehensive systematic search of two databases was performed, and information on patient characteristics, symptomatology, and treatment was extracted from eligible articles. A total of 56 cases were included in our analyses. Forty patients were male, 16 were female, with an average age of 21.38 years at the time of diagnosis. Assumed etiology was previous trauma in 35 cases, previous cranial surgery in 17 patients, and birth trauma and epidural bleeding after the utilization of the Mayfield clamp in 1 case each. The origin remained unclear in two cases. The time between trauma or surgery and diagnostics ranged between one and a half weeks and 50 years, with a median of 4 years (SD 9.8 years). The symptoms were very heterogeneous, ranging from acute neurological deterioration to chronic symptoms. In 15 cases, patients were asymptomatic, and cranial imaging was performed as part of a new trauma or a screening for other disease. Forty-one patients received surgical treatment by craniotomy and hematoma evacuation, and 13 patients were treated conservatively. In two cases, the liquid hematoma portion was aspirated through a burr hole. The localization of calcified or ossified EDH was mainly supratentorial. Young male patients most commonly present with calcified or ossified EDH after trauma, according to the epidemiological trend of acute EDH. Clinical presentation varies from asymptomatic to severe neurological deficits and signs of increased intracranial pressure. There is no standardized treatment; decisions must be made on an individual basis. Calcification Chronic epidural hematoma Cranial trauma Ossification Dewey 616.8 61 Département des neurosciences cliniques 226 false 513 Groupe Schaller Karl Lothard (neurochirurgie) 851 Neurotrauma reports 5 1 237194a4-a259-486e-afb1-a718302d7bea Article (Published version) Public Article_scientifique_from_europePmc.pdf 1690565 application/pdf CC BY-4.0 6de894f0a7a45a2189e94d9a17970af1d420cca77718e18c91a0e229f4f7e47c 077f43a1-b640-475a-9190-d3f0fb9ee250 Supplemental data Public neur.2024.0065_appendix.pdf 806810 application/pdf Table of studies 2be5981dadf90e390fa3da0e969bb220cc4506ed22a62021fb74706c292e95f9 1e623cee-5f17-442b-a876-4886088c2526 Appendix Public neur.2024.0065_appendix1.pdf 11318 application/pdf Search Strategies 0f71053a490511fa9a86005b9ed59f418fd21748251995f0e13e6c81fb54a958 openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques

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Ossification of Cranial Epidural Hematomas: A Systematic Review of Management Strategies and Presentation of an Illustrative Case	Neurotrauma reports			2024	31	128

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