AB089. Improving decision-making in traumatic brain injury patients via 3D volumetric analysis of epidural haematoma.

Abstract

Epidural haematoma (EDH) is a common finding in many traumatic brain injury scenarios, which necessitates surgical evacuation if the volume equals 30 cm3. The Tada formula, despite its convenience, have been observed to inaccurately depict haemorrhage volume, which can lead to inappropriate decision-making. Objective: (I) to determine if there are statistical differences between EDH volumes as calculated using three-dimensional (3D) software versus Tada's formula; and (II) whether this difference leads to differences in treatment options. Computed tomography (CT)-scan of 15 traumatic brain injury (TBI) patients with EDH in January-February 2024 were obtained, and the volumetric analysis was performed using the (I) 3D Slicer software; and the (II) Tada formula for each scan. In addition, characteristics such as patient demographics and region were noted. We performed a paired t-test to scrutinise whether there were any differences between the volumes obtained via the two methods. There was a significant difference (P≤0.05) between the EDH volumes as calculated via 3D software and the Tada formula. We also noted that some patients who should have been treated surgically were not operated on, and vice versa. The process of 3D segmentation only takes an average of 8.2 minutes per patient; which is comparable to using the Tada formula. The inaccuracy of the Tada formula could be attributed to the irregular volume of the bleeding foci, contrary to the prototypical biconvex shape. 3D segmentation should be routinely employed in EDH and other TBI-related haemorrhage cases when available, to aid in decision-making. Extensive development is needed to explore the utility of 3D software in emergency neurosurgery.