{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T04:02:58Z","timestamp":1691294578590},"reference-count":15,"publisher":"Scientific Scholar","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ruralneuropractice.com"],"crossmark-restriction":true},"short-container-title":["JNRP"],"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>\n<jats:bold>Objective<\/jats:bold>\u2003Epidural hematoma (EDH), most often caused by rupture of the middle meningeal artery secondary to head trauma with fracture of the temporal bone, is a potentially fatal condition that can lead to elevated intracranial pressure, herniation, and death within hours following the inciting traumatic incident, unless surgical evacuation is accomplished. Several markers have been found to be associated with hematoma expansion in intracerebral hemorrhage (ICH) patients, including: the CT Blend Sign, Swirl Sign, and Black Hole Sign. This study aims to examine these markers, along with intradural air close to or in the region of an EDH and\/or close to a significant fracture, fractures involving the skull base, and complicated (i.e., comminuted or displaced) fractures for possible associations to EDH growth in the pediatric population. Predicting hematoma growth is a crucial part of patient management, as surgery can be a life-saving intervention.<\/jats:p>\n<jats:p>\n<jats:bold>Methods<\/jats:bold>\u2003Scans from all pediatric patients with EDH from 2012 to 2019 across two separate health systems were examined and measurements were taken to determine whether these additional factors are of predictive value. Specifications such as length, transverse, and height measurements were taken from CT images.<\/jats:p>\n<jats:p>\n<jats:bold>Statistical Analysis<\/jats:bold>\u2003The average percent change in the hematoma measurements was used to determine which predictive factors were associated with a \u201cnoteworthy increase,\u201d namely, an increase of greater than 25%. Additionally, the average percent change in hematoma size was evaluated for patients whose original imaging showed either all three CT signs or intradural air in all three specified locations.<\/jats:p>\n<jats:p>\n<jats:bold>Results<\/jats:bold>\u2003Most of the proposed markers were associated with EDH growth in this cohort. The established CT signs were also supported. This is notable, as most of the research on these signs has been in adult populations rather than pediatric.<\/jats:p>\n<jats:p>\n<jats:bold>Conclusions<\/jats:bold>\u2003Adding these novel imaging signs could aid in the decision to operate on versus observe PEDH patients, thereby preventing unnecessary procedures or preserving brain function quickly when surgery is indicated. This study serves as a starting point for several other investigations into the validity of the proposed markers as well as a reevaluation of the current signs in the pediatric population.<\/jats:p>","DOI":"10.1055\/s-0041-1735327","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T22:58:39Z","timestamp":1632869919000},"page":"689-693","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel Predictive Markers on Computed Tomography for Predicting Early Epidural Hematoma Growth in Pediatric Patients"],"prefix":"10.25259","volume":"12","author":[{"given":"Avery A.","family":"Kopacz","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hunter","family":"Miears","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reagan A.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laszlo","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"10.1055\/s-0041-1735327\/ref-1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.wneu.2019.05.084","article-title":"Middle meningeal artery embolization for the treatment of an expanding epidural hematoma","volume":"128","author":"Zussman","year":"2019","journal-title":"World Neurosurg"},{"key":"10.1055\/s-0041-1735327\/ref-2","doi-asserted-by":"crossref","first-page":"276","DOI":"10.4103\/MJBL.MJBL_47_19","article-title":"Management of epidural hematoma in the pediatric age group","volume":"16","author":"Al-Mamoori","year":"2019","journal-title":"Med J Babylon"},{"issue":"8","key":"10.1055\/s-0041-1735327\/ref-3","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1161\/STROKEAHA.115.009185","article-title":"Blend Sign on computed tomography: novel and reliable predictor for early hematoma growth in patients with intracerebral hemorrhage","volume":"46","author":"Li","year":"2015","journal-title":"Stroke"},{"issue":"5","key":"10.1055\/s-0041-1735327\/ref-4","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/S0967-5868(99)90038-3","article-title":"Chronic epidural haematoma: a report of 10 cases and review of the literature","volume":"6","author":"Liu","year":"1999","journal-title":"J Clin Neurosci"},{"issue":"1","key":"10.1055\/s-0041-1735327\/ref-5","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1227\/00006123-199301000-00004","article-title":"Delayed and progressive brain injury in closed-head trauma: radiological demonstration","volume":"32","author":"Stein","year":"1993","journal-title":"Neurosurgery"},{"issue":"4","key":"10.1055\/s-0041-1735327\/ref-6","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1227\/01.NEU.0000197101.68538.E6","article-title":"Acute traumatic intraparenchymal hemorrhage: risk factors for progression in the early post-injury period","volume":"58","author":"Chang","year":"2006","journal-title":"Neurosurgery"},{"issue":"5","key":"10.1055\/s-0041-1735327\/ref-7","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00234-010-0659-8","article-title":"Early CT signs of progressive hemorrhagic injury following acute traumatic brain injury","volume":"53","author":"Tong","year":"2011","journal-title":"Neuroradiology"},{"key":"10.1055\/s-0041-1735327\/ref-8","doi-asserted-by":"crossref","first-page":"134905","DOI":"10.1155\/2012\/134905","article-title":"Progressive epidural hematoma in patients with head trauma: incidence, outcome, and risk factors","volume":"2012","author":"Chen","year":"2012","journal-title":"Emerg Med Int"},{"issue":"1","key":"10.1055\/s-0041-1735327\/ref-9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.3171\/jns.1985.63.1.0030","article-title":"Delayed onset of traumatic extradural hematoma","volume":"63","author":"Borovich","year":"1985","journal-title":"J Neurosurg"},{"issue":"12","key":"10.1055\/s-0041-1735327\/ref-10","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1001\/jamaneurol.2016.2619","article-title":"Association of key magnetic resonance imaging markers of cerebral small vessel disease with hematoma volume and expansion in patients with lobar and deep intracerebral hemorrhage","volume":"73","author":"Boulouis","year":"2016","journal-title":"JAMA Neurol"},{"issue":"7","key":"10.1055\/s-0041-1735327\/ref-11","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1161\/STROKEAHA.116.013186","article-title":"Black hole sign: novel imaging marker that predicts hematoma growth in patients with intracerebral hemorrhage","volume":"47","author":"Li","year":"2016","journal-title":"Stroke"},{"issue":"3","key":"10.1055\/s-0041-1735327\/ref-12","doi-asserted-by":"crossref","first-page":"520","DOI":"10.3174\/ajnr.A0859","article-title":"Contrast extravasation on CT predicts mortality in primary intracerebral hemorrhage","volume":"29","author":"Kim","year":"2008","journal-title":"AJNR Am J Neuroradiol"},{"issue":"2","key":"10.1055\/s-0041-1735327\/ref-13","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.surneu.2007.10.032","article-title":"Mixed-density extradural hematomas on computed tomography-prognostic significance","volume":"71","author":"Pruthi","year":"2009","journal-title":"Surg Neurol"},{"issue":"4","key":"10.1055\/s-0041-1735327\/ref-14","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1161\/01.STR.0000259633.59404.f3","article-title":"CT angiography \u201cspot sign\u201d predicts hematoma expansion in acute intracerebral hemorrhage","volume":"38","author":"Wada","year":"2007","journal-title":"Stroke"},{"key":"10.1055\/s-0041-1735327\/ref-15","doi-asserted-by":"crossref","first-page":"811","DOI":"10.12659\/AJCR.895231","article-title":"Conservative vs. surgical management of post-traumatic epidural hematoma: a case and review of literature","volume":"16","author":"Maugeri","year":"2015","journal-title":"Am J Case Rep"}],"container-title":["Journal of Neurosciences in Rural Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ruralneuropractice.com\/novel-predictive-markers-on-computed-tomography-for-predicting-early-epidural-hematoma-growth-in-pediatric-patients\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ruralneuropractice.com\/novel-predictive-markers-on-computed-tomography-for-predicting-early-epidural-hematoma-growth-in-pediatric-patients\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T04:40:03Z","timestamp":1691210403000},"score":1,"resource":{"primary":{"URL":"https:\/\/ruralneuropractice.com\/novel-predictive-markers-on-computed-tomography-for-predicting-early-epidural-hematoma-growth-in-pediatric-patients\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,28]]},"references-count":15,"alternative-id":["10.1055\/s-0041-1735327"],"URL":"https:\/\/doi.org\/10.1055\/s-0041-1735327","relation":{},"ISSN":["0976-3147"],"issn-type":[{"value":"0976-3147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,28]]},"article-number":"689"}}