{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T04:30:05Z","timestamp":1744173005510,"version":"3.40.3"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Absent pupillary reaction occasionally heralds a poor prognosis following severe head injury. The purpose of the study was to evaluate the outcome of all patients who underwent acute evacuation of epidural hematoma (EDH) despite absent bilateral pupillary reaction.<\/jats:p><jats:p>\n          Methods\u2003The Trauma Quality Improvement Program (TQIP) database for the calendar years 2017 and 2018 was accessed for the study. Adult patients \u226518 years of age who sustained severe traumatic brain injury (TBI) with the diagnosis of EDH and underwent evacuation of the hematoma were included in the study. The patients' characteristics, injury severity score (ISS), Glasgow Coma Scale (GCS) score, midline shift, and comorbidities were compared between patients who had absence of both pupillary reaction (ABPR) and those who presented with presence of both pupillary reaction (PBPR). The primary outcome of the study was in-hospital mortality. Propensity score matching analyses were performed for the study.<\/jats:p><jats:p>\n          Results\u2003No significant differences were found between the ABPR and PBPR groups regarding the median age (37 years [interquartile range (IQR): 26\u201353] vs. 40 years [IQR: 28\u201355]), gender (males; 81.9 vs. 79.5%), median ISS (29 [25.5\u201334] vs. 27 [25\u201333]), GCS score (3 [3\u20134] vs. 3 [3\u20133], presence of significant midline shift (75.9 vs. 79.5%), and comorbidities. The patients who presented with ABPR had a significantly higher mortality (34.9 vs. 10.8%; p\u2009=\u20090.002). A higher number of patients were discharged to skilled nursing and rehabilitation facilities (16.7 vs. 10.8% and 46.3 vs. 41.9%, respectively; p\u2009=\u20090.045).<\/jats:p><jats:p>\n          Conclusion\u2003Approximately 65% of severe TBI patients survived after the evacuation of the EDH despite the absence of pupillary reaction.<\/jats:p>","DOI":"10.1055\/s-0044-1786535","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T22:40:15Z","timestamp":1717195215000},"page":"247-253","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Outcomes of Epidural Hematoma in Trauma Patients with Absent Pupillary Reactions: A National Trauma Data Analysis"],"prefix":"10.1055","volume":"86","author":[{"given":"Nasim","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Trauma & Surgical Critical Care, Jersey Shore University Medical Center, Neptune, New Jersey, United States"},{"name":"Hackensack Meridian School of Medicine, Nutley, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-Hong","family":"Kuo","sequence":"additional","affiliation":[{"name":"Office of Research Administration, Hackensack Meridian Health Research Institute, Nutley, New Jersey, United States"},{"name":"Hackensack Meridian School of Medicine, Nutley, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Hoon","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Trauma & Surgical Critical Care, Jersey Shore University Medical Center, Neptune, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"ref1","first-page":"S7","article-title":"Surgical management of acute epidural hematomas","volume":"58","author":"M R Bullock","year":"2006","journal-title":"Neurosurgery"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/0303-8467(92)90069-F","article-title":"Bilateral traumatic extradural haematomas: report of 12 cases with a review of the literature","volume":"94","author":"S K Gupta","year":"1992","journal-title":"Clin Neurol Neurosurg"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s007010050332","article-title":"The prognostic importance of the volume of traumatic epidural and subdural haematomas revisited","volume":"141","author":"W A van den Brink","year":"1999","journal-title":"Acta Neurochir (Wien)"},{"issue":"6753","key":"ref4","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.301.6753.629","article-title":"Steps towards cost-benefit analysis of regional neurosurgical care","volume":"301","author":"J D 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Travma Acil Cerrahi Derg"},{"issue":"08","key":"ref15","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1136\/emermed-2014-204260","article-title":"Prognosis of patients with bilateral fixed dilated pupils secondary to traumatic extradural or subdural haematoma who undergo surgery: a systematic review and meta-analysis","volume":"32","author":"J Scotter","year":"2015","journal-title":"Emerg Med J"}],"container-title":["Journal of Neurological Surgery Part A: Central European 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