1316 Chronic Epidural Hematoma: A Systematic Review and Meta-Analysis

Abstract

Abstract Background Epidural hematoma constitutes a common condition in neuro-traumatology. If its acute form is well known, the chronic one remains less described. In this study, we aimed to evaluate the epidemiology, presentations, management, and outcomes of chronic epidural hematoma (CEDH). Method Systematic searches of PubMed, Google Scholar, and ScienceDirect were performed from a database searching for all studies reporting CEDH. Pooled statistics were calculated using measures of central tendency and spread. Results Totally, 3009 studies were identified, of which 95 were included with 359 patients. CEDH was more common in intracranial than spinal (91.9% vs 8.1%). The average age of onset was 37.2 +/- 4.83 years. The common cause found was trauma (n = 279; 77,72%) with 271 (97.1%) cases for the head and 8 (2,9%) cases for the spine. The median delay between the trauma and the first symptoms was 13.31 +/- 3.43 days in intracranial level and 16.37 +/- 5.87 days in spinal level. CT-scan constituted the main diagnosis tool. The lesion was predominantly located in the temporal region at the intracranial level and lumbar region at the spinal level. Craniotomy and laminectomy constituted the most reported treatment option respectively at the intracranial and spinal level. The outcome was commonly uneventful. Correlation and Regression test for publication bias assessment show no significant Funnel plot asymmetry with high p-value (p = 0.8458 and p = 0.9596, respectively). Conclusions There was no clear risk factor found for CEDH. The treatment was mostly surgical.