Acute Subdural Hematoma: Severity of Injury, Surgical Intervention, and Mortality

Abstract Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clinical presentation was altered sensorium (98.25%). The most common comorbidity was hypertension (n = 32, 28.07%). GCS at admission, severity of injury, pupillary changes, and best motor response (p < 0.0001) were significantly associated with surgical outcome. Conclusion GCS at admission, severity of injury, pupillary changes, and best motor response were significantly (p < 0.05) associated with surgical outcome. Age and gender of patients were not found to be significantly associated.

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Delayed Surgical Intervention in Acute Subdural Hematoma

Cureus ◽

10.7759/cureus.11592 ◽

2020 ◽

Author(s):

Omar S Akbik ◽

Robert Starling ◽

Ross Green ◽

Yiliang Zhu ◽

Jeremy Lewis

Keyword(s):

Subdural Hematoma ◽

Surgical Intervention ◽

Acute Subdural Hematoma

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Delayed Treatment of Acute Subdural Hematomas: Retrospective Outcome Analysis of 215 Patients

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6566 ◽

2021 ◽

Vol 9 (B) ◽

pp. 779-785

Author(s):

Kanat Akhmetov ◽

Serik Akshulakov ◽

Yerzhan Adilbekov ◽

Altynshash Jaxybayeva ◽

Mariya Dmitriyeva ◽

...

Keyword(s):

Subdural Hematoma ◽

Surgical Intervention ◽

Basic Result ◽

Treatment Method ◽

Acute Subdural Hematoma ◽

Outcome Analysis ◽

Craniocerebral Injury ◽

Delayed Treatment ◽

Reduce Risk

BACKGROUND: The preferred treatment method for acute subdural hematoma (aSDH) is surgical intervention. AIM: We aimed to show that, regardless of the good results of surgical treatment, conventional delayed treatment might be very useful in some situations and might lead to chronicity of hematoma as well as reduction of surgical intervention scope and reduce risk of anesthesia. It might also give rise to spontaneous resorption of hematoma. METHODS: In the period March 1, 2013–March 1, 2020, we retrospectively examined 215 aSDH patients. The basic result of the outcome analysis was evaluated on the basis of the Glasgow Outcome Scale (GOS) at discharge after 3-month and 6-month follow-up. RESULTS: A total of 215 patients with aSDH and minor or moderate brain injury were examined, while applying conventional delayed treatment, the following results were obtained: large craniotomy was carried out in 123 patients (57.2%) on the 2nd–3rd day of observation, small craniotomy with drainage was applied in 29 patients (13.5%) and spontaneous resorption of subdural hematoma occurred in 63 patients (29.3%). The median score as per the Glasgow Coma Scale at admission to the hospital was 11.4. CONCLUSION: This study showed that conventional delayed treatment applied in patients with aSDH and minor or moderate craniocerebral injury might lead to chronicity and resorption of aSDH. The outcomes as per the GOS scale also showed good data three and 6 months after hospitalization.

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