DOI: https://doi.org/10.36347/sjams.2026.v14i10.002

Pages: 1187-1193

Background: Traumatic epidural hematoma (EDH) is a potentially life-threatening complication of traumatic brain injury and may occur either as an isolated intracranial lesion or together with other traumatic intracranial injuries. The presence of concomitant lesions may increase the overall neurological and radiological severity of injury and influence clinical management. However, data comparing isolated and nonisolated EDH in the Bangladeshi setting remain limited. Objective: To compare the clinical and radiological characteristics of patients with isolated and nonisolated traumatic EDH and to assess differences in neurological severity and associated intracranial injury between the two groups. Methods: This prospective observational study was conducted in the Department of Neurosurgery at a tertiary care hospital in Chittagong, Bangladesh, from January 2024 to December 2024. A total of 100 adult patients with traumatic EDH confirmed by initial non-contrast computed tomography (NCCT) of the brain were included. Patients were equally classified into isolated EDH (n=50) and nonisolated EDH (n=50) groups according to the presence or absence of additional intracranial traumatic lesions. Demographic, clinical, and CT findings were recorded prospectively. Continuous and categorical variables were compared using appropriate statistical tests, with p<0.05 considered statistically significant. Results: The median age was significantly higher in the nonisolated EDH group than in the isolated group (45 [IQR: 29–58] vs. 34 [IQR: 22–51] years; p=0.012). Male predominance was identical in both groups (76.0%; p=1.000). Focal neurological deficits were more frequent in nonisolated EDH (20.0% vs. 6.0%; p=0.037). Patients with nonisolated EDH had significantly lower median baseline GCS (11 [IQR: 6–14] vs. 15 [IQR: 12–15]) and GCS motor scores (5 [IQR: 2–6] vs. 6 [IQR: 6–6]); both p<0.001. Mild TBI was more common in isolated EDH (74.0% vs. 30.0%), whereas moderate-to-severe TBI was