Surgical Management of Acute Traumatic Subdural Haematoma: A Single-Center Prospective Study

ABSTRACT

Background: Acute SDH is seen in approximately one third of patients with severe TBI and in half to more than two thirds of those undergoing hematoma evacuation. Acute SDH is associated with high rates of mortality. Surgical treatment is still Controversial. an analysis of our institutional data is performed in patients with traumatic ASDH to study factors determining clinical outcome. Methods: 50 patients with ASDH underwent surgical treatment are taken for prospective study in our Neurosurgery department, Rangaraya Medical College, Kakinada, between Dec.,2015 to Dec.,2017. Information including patient characteristics, treatment modality, radiologic features, and functional outcome were analyzed. Outcome was assessed according to the Glasgow Outcome Scale (GOS) at 1 month. Furthermore, a multivariate analysis was performed to identify independent predictors of functional outcome. Results: 22% of patients with ASDH after Decompressive Craniectomy achieved favorable outcome. <60 years male patients are commonly effected. Road Traffic Accidents are common mode of injury. Right side Decompressive Craniectomies are commonly done. In this study the overall mortality rate is 60%. Conclusions: A detailed data is provided on patients with ASDH. Despite poor GCS at admission & dilated pupils favorable outcome may be achieved in many patients after Decompressive Craniectomy. Nevertheless, careful individual decision making is necessary for each patient, especially when signs of cerebral herniation have persisted for a long time.