الفهرس 
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Abstract
Extradural haematoma is a well recognized and most rewarding neurosurgical emergency.
It must be recognized and evacuated early to prevent potential mortality and morbidity.and we are aiming to study the factors affecting the outcome of extradural heamatom evacuation to lower and even prevent mortality and morbidity of it.
In our study We operated upon 50 patients with the oldest was 63 years old and the youngest was 3 years old, with mean age of 38.48 years ,as regard sex we operate 14 females and 36 males, according to the cause of trauma the most common was road traffic accident in 23 patients and, followed by falling from high in 14 patients, then assault in 11 patients, and animal kick in 2 patients, according to the clinical presentation The 50 patients presented to us with several symptoms, the most common was manifestation of increase intracranial tension as headache and vomiting in 38 cases, followed by Loss of consciousness in 28 patients and 19 cases have typical lucid interval followed by disturbed conscious level in 12 cases, then weakness in 8 cases, then unilateral dilated pupil in 5 cases followed by fits in 2 cases, while 2 cases were neurologically free and one case has bilateral dilated fixed pupil., according to the site of EDH the most common was temperoparietal in 16 patients followed by temoporal lobe in 13 patients then parietal lobe in 8 patients and frontoparietal in 6 patients followed by frontal lobe in 3patients and posterior fossa in 3patients and it was bilateral in one patient., according to the size of EDH We operate 50 patients the size of EDH the most common range of size was between 20-30cc in 27 patients then between30-40cc in 17 patients then between 40-50cc in 5 patients and more than 50cc in only one patient .,as regard the time pass from trauma to operation we operate 14 patients in the 2nd hour and also 14 patients in the 3rd hour followed by 10 patients in the 4th hour then 6 patients in the 5th hour and 4 patients after more than 5 hours and only 2 patients in the 1st hour . and as regard outcome 39 patients show full recovery and 7 patients show neurological deficit and 4 patients died and no one show vegetative state and from the 46 patients who not died 6 patients develop superficial wound infection and one patients show recollection of EDH and reoperation.
The use of computerized tomography was found to be mandatory in diagnosis of EDH and evaluation the site and size of EDH and no other investigation can replace it .
The choice of surgical approach remains that of surgeon guided by the site and size of EDH and many other factors.
Conclusion
Our study designed to evaluate factors affecting outcome of EDH evacuation to draw routs that we will follow to decrease the morbidity and mortality of EDH and even to reach to the level of zero mortality from EDH the most emergent neurosurgical trauma .
This study included fifty patients with traumatic EDH of different sex and age and mode of trauma and we found that the age and sex and mode of trauma play no rule in the outcom of EDH but in the other hand we found that the RTA is the most common mode of trauma and so with stander roads and traffic rules we can decrease the frequency of EDH.
The EDH is more common in middle aged males as they are the most active part of the community.
As regard the site of EDH we found that the site play minimal rule in the outcome of EDH and as the most common sites was temperoparietal and temporal so mostly the middle meningial artery is the most common source of EDH and the posterior fossa is the most dangerous site as one case of the 3 patient presented with posterior fossa EDH died (33.3%) followed by temporal lobe EDH as 2(6.5%) cases from the 15 case died but the site is not a modifiable factor .
AS regard the size and time from the trauma to evacuation and clinical presentation of EDH thy are the major factors that affect EDH .
The time from trauma to evacuation is a major factor not by itself but through its effect in the size of EDH and the conscious level and other clinical presentation.
The size of EDH play a role through its effect in the clinical presentation and conscious level as the 4 patients who died the size of EDH was more than 40cc
The clinical presentation especially the conscious level is the main factor affecting the outcome as all the 4 cases who died the emergency room presentation GCS was less than 8
So to improve the morbidity and mortality of EDH qualified primary health centers with available computerized tomography at it which allow rapid diagnosis and then available rapid transport method to the centers where qualified neurosurgions and neurosurgery operative room and available pos operative ICU place if need is the key.