Acute Subdural Hematoma: An Analysis of 244 Operated Cases

This study is a retrospective clinical analysis of two hundred forty-four consecutive cases of acute subdural hematoma which were confirmed by operation during the last five years at the Department of Neurosurgery of the Dong-guk University Hospital. The authors have attempted, through this analysis to identify the factors affecting the outcome of acute subdural hematoma. A favorable outcome occurred in 40%, and an unfavorable outcome in 21% of patients at the time of discharge while a death ocurred in 39% of the cases. We have concluded that initial GCS, pupillary status, systolic arterial blood pressure, FDP vaules, presence or absence of skull fracture. IICP findings on brain CT, hematoma amount, and associated intracranial lesions are all prognostic factors, although the timing of operation did not reflect a significant difference in the outcome, however the sooner the intracranial hematoma lesion is evacuated, the better the outcome will be.

Clinical Analysis of Lymphocyte Population Changes in Severe Head Injured Patients Using Flow Cytometry

Despite advancement in diagnosis and progress in the management of intracranial pressure, infection remains a common complication following severe head injury. This following study attempts to better define the cell mediated immunity that decreased immediately following severe head injury. Twenty-five patients admitted with severe head injury(mean Glasgow Coma Scale, 5.32) were studied at the emergency rooms. The control group consisted of 25 mildly head-injured patients requiring hospital observation. Phenotyping of peripheral blood lymphocytes(PBL), determined by flow cytometry using monoclonal antibodies to lymphocytes subpopulation and HLA-DR receptors, was performed immediately following head injury. When severely head-injured patients were compared with controls, it was observed that the total T-cell counts(p<0.01) were markedly decreased, whereas the NK cell counts(p<0.01) were found to be increased. Infection rate of the study group was 44% and the majority of infections occur within the first 10 days after sever head injury. The results of this study suggests that severely head-injured patients had a decreased T-cell population and subpopulation in lines with higher infection rate.