Objective: Aim of current study is to determine and compare the outcomes of surgical versus conservative treatment of traumatic extradural hematoma in the supratentoral region.

Study Design: Prospective/ Randomized study

Place and Duration: Conducted at Neurosurgery department of Bacha khan Medical College / Mardan Medical Complex Mardan and Frontier Medical and Dental College Abbottabad for duration of six months from April 2021 to September 2021.

Methods: There were one hundred and eight patients of both genders with ages 14-55 years were included. Included patients had traumatic extradural hematoma in the supratentoral region. Demographically detailed included cause of trauma, age and gender were calculated after taking informed written consent. CT scan was performed among all the patients to diagnose hematoma. Patients were equally categorized into two groups. Group I received surgical treatment and group II received conservative treatment. Symptoms and complications among both groups were assessed. Glasgow comma score was used. Post treatment outcomes were compared among both groups by using t-test. We used SPSS 21.0 version to analyze complete data.

Results: Among 54 patients in group I 31 (57.4%) cases were males and 23 (42.6%) patients were females and in group II 35 (64.8%) were male patients and 19 (35.2%) females. Majority of the patients 65 (60.2%) among both groups were in age group 21-35 years followed by 14-20 years 30 (27.8%) cases. Road traffic accident was the most common cause found in 27 (50%) and 29 (53.7%) in groups I and II. Consciousness loss, vomiting and headache were the most common symptoms. Mean hematoma volume in group I was 29.11±6.38 ml and in group II 22.16±8.47 ml. Mean GCS in group I was 15.07±3.13 and in group II was 16.18±5.38. We found that conservative treatment presented favorable outcomes 53 (98.4%) as compared to surgical treatment in 50 (92.6%) cases. No any mortality found in this study.

Conclusion: We concluded in this study that the conservative for the extradural hematoma in supratentoral region was effective and safe treatment as compared to surgical. Most common cause was RTA. There is no any mortality found in both treatments.

Keywords: Supratentoral Region, Extradural hematoma, GCS, Outcomes