Prediction of Prognosis in Patients with Epidural Hematoma by a New Stereological Method

Prediction of Prognosis in Patients with Epidural Hematoma by a New Stereological Method

ERDAL KALKAN,¹ BASAR CANDER,² MEHMET GUL,² SADIK GIRISGIN,² HAKAN KARABAGLI³ and BUNYAMIN SAHIN⁴

¹Department of Neurosurgery, School of Meram Medical, Selcuk University, Konya, Turkey
²Department of Emergency Medicine, School of Meram Medical, Selcuk University, Konya, Turkey
³Division of Neurosurgery, The Health Ministry Numune Hospital, Konya, Turkey
⁴Department of Anatomy, School of Medicine, Ondokuz Mayis University, Samsun, Turkey

Epidural hematoma (EH) is a serious clinical event observed in 2% of head trauma patients. Studies regarding the effects of epidural hematoma volume (EHV) on prognosis are not sufficient. In this study, we applied the volume fraction approach of the stereological method to estimate the hematoma to brain volume fraction (HBVF), and investigated the relation between the HBVF and prognosis. Fifty-nine EH patients (46 male and 13 female subjects, with average age of 21 years) admitted to the emergency clinic were included. The HBVF was estimated on the printed films of cranial computed tomography scans. For this purpose, common point counting grids were superimposed over the scan frames. According to the clinical results, patients were divided into three groups as complete recovery (43), disability (8) and exitus (8). The HBVF was compared with the clinical results. HBVF was determined as 4.6% in the patients with recovery, 8.1% in disability, and 7.6% in exitus patients. The HBVF values were lowest in recovery patients, and the difference between the recovery and the other two groups was statistically significant (p = 0.007). However, there was no statistically significant difference in HBVF between disability and exitus patients (p > 0.05). In conclusion, the HBVF can be an important tool to determine prognosis, and it can be measured using the volume fraction approach of stereological methods as developed in the present study.

keywords —— stereology; volume; volume fraction; hematoma to brain volume fraction; prognosis

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Tohoku J. Exp. Med., 2007, 211, 235-242

Correspondence: Dr. Erdal Kalkan, Armagan Mah. Sahne Sok. No: 4, 42090 Meram, Konya, Turkey.

e-mail: erdalkalkan62@yahoo.com