An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 223 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Ahead of Print

Prognostic value of swirl sign in acute epidural hemorrhage

1 Department of Neurosurgery, Gandhi Medical College and Hospital, Telangana, India
2 Department of Neurosurgery, SVS Medical College and Hospital, Mahbubnagar, Telangana, India
3 Department of Critical Care Medicine, Max Hospital, Saket, New Delhi, India

Correspondence Address:
Hemant Kumar Beniwal,
Department of Neurosurgery, 4th Floor, Gandhi Medical College and Hospital, Padma Rao Nagar, Secunderabad - 500 003, Telangana
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_68_21

Objective: The purpose of this study is to analyze and evaluate the incidence, prognostic value, and impact of swirl sign on the outcome of patients who underwent surgical treatment for epidural hematoma. Materials and Methods: A retrospective analytical study on 307 acute epidural hematoma (AEDH) patients with and without swirl sign was conducted at our hospital between 2015 and 2019. All the patients in this study were treated initially as per the protocols of advanced trauma life support and surgically treated by craniotomy and evacuation of epidural hematoma. Patients with other concomitant intracerebral injuries such as subdural hematoma and contusion and those who were managed conservatively were excluded from the study. Various factors such as age, sex, mechanism of injury, Glasgow Coma Scale (GCS) score at admission, time from injury to surgery, preoperative mydriasis, location of bleed, midline shift, location of fracture, volume of hematoma, duration of stay in the hospital, and GCS score at discharge were taken into consideration and compared in between patients with and without swirl sign. Outcomes were assessed at the end of 6 months using the Glasgow Outcome Scale. Results: Of the 307 patients who were operated for epidural hemorrhage, 92 had swirl sign (29.96%) and the rest had no swirl sign. Univariate analysis revealed a significant correlation between the presence of swirl sign and age, preoperative mydriasis, and time from injury to surgery. The patients with the swirl sign had an unfavorable outcome at the end of 6 months which was statistically significant. Conclusion: It can be concluded that those patients with swirl sign in AEDH had an unfavorable outcome compared to those without swirl sign. Therefore, aggressive treatment and early surgery play an important role in the outcomes of the patients.

Print this article
  Search Pubmed for
    -  Beniwal HK
    -  Reddy MS
    -  Rao GP
    -  Srikrishnaditya M
    -  Beniwal A
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded54    

Recommend this journal