Analysis on clinical characteristics of rapid and non-rapid resolution of traumatic acute subdural hematoma / 中华创伤杂志

ABSTRACT

Objective To compare the clinical and imaging characteristics of traumatic acute subdural hematoma acute subdural hematoma with rapid resolution and those without rapid resolution.Methods A retrospective case-control analysis was conducted on the clinical data of 60 traumatic acute subdural hematoma patients with hematoma thickness ≥ 5 mm admitted to Second Affiliated Hospital of Shantou University Medical College from January 2011 to May 2018.There were 37 males and 23 females,aged 18-80 years [(47.0±16.9)years].There were 27 patients in the rapid resolution group and 33 patients in the non-rapid resolution group.Coagulation function [prothrombin time(PT)and international normalized ratio(INR)] on admission,hospital stay,Glasgow outcome scale(GOS),and brain CT results were compared between the two groups.Results The PT and INR values in the rapid resolution group were(11.9±2.1)s and 1.1±0.2 respectively,while those in the non-rapid resolution group were(10.8±1.0)s and 1.0±0.1 respectively,with significant differences(P＜0.05).There was no significant difference in hospital stay and GOS between the two groups(P＞0.05).The thickness of subdural hematoma of the two groups in the first CT scanning was(8.2±2.3)mm and(7.3±1.8)mm,respectively,with no statistically significant difference(P＞0.05).In the second CT scanning,the hematoma thickness in the rapid resolution group was significantly lower than that in the non-rapid resolution group [(2.7±1.9)mm vs.(6.6±2.1)mm](P＜0.01).The incidence of low density zone between the hematoma and intracranial plate was statistically higher in rapid resolution group than that in non-rapid resolution group(93％vs.36％)(P＜0.01).The incidence of subarachnoid hemorrhage(SAH)increase wassignificantly higher in rapid resolution group than that in non-rapid resolution group in the second CT scan(74％vs.15％)(P＜0.01).The conversion rate of acute subdural hematoma to subacute or chronic subdural hematoma was 4％in the rapid resolution group,which was significantly lower than 18％in the non rapid resolution group(P＜0.05).Conclusions The abnormal coagulation function and low density zone indicated by CT are two important indicators of rapid resolution in patients with traumatic acute subdural hematoma.The risk of conversion from acute into subacute or chronic subdural hematoma is lower in rapid resolution of traumatic acute subdural hematoma,suggesting that rapid resolution may be one of the prognostic indicators of ASDH patients.