Acute subdural haematoma and its various aspects; A Clinical study

ABSTRACT

Acute subdural hematoma is one of the most common types of intra cranial hematoma caused by trauma accounting for more than 20% severe head injuries and resulting in highest mortality. Various studies have been made to understand the consequences and surgical outcomes of SDH patients. Therefore, the present study was designed to evaluate the clinical spectrum and assess the outcome of surgery in SDH patients. Methods: Present study included 50 patients of both sexes from 1 to 70 years age group with head injury, diagnosed to have traumatic subdural haemorrhage. Clinical examination included pupillary anisocoria, hemodynamic status, extent of hematoma either focal or diffuse, midline shift, GCS, status of basal cisterns, blood pressure. All the patients included in the study underwent surgical procedure for the removal of haematoma. Results: There was 100% mortality rate in patients with bilaterally dilated pupils. Whereas, there was 24.13% and 5.5% mortality rate respectively in unilateral dilated and normal pupil patients. Most of the patient had GCS <8 (40%), followed by GCS 9-12 (34%) and GCS 13-15 (26%) at the time of admission in the hospital. Further, GCS <8, GCS 9-12and GCS 13-15 were found in 32%, 40% and 28% correspondingly in patients after resuscitation. Conclusion: Findings of present study showed that there was an inverse relation between interval between injury and surgery with prognosis, Greater the interval poor will be outcome of surgery. Basal cistern obliteration is a reliable marker of increased intra cranial pressure which is responsible for poor outcome. Further, hypotension is also one of the important factors affecting the outcome of surgery in SDH patients.