Surgical Outcome of Organised Chronic Subdural Hematoma With Internal Septae in a Tertiary Care Hospital

  • MUHAMMAD NAWAZ KHAN Department of Neurosurgery, Hayatabad Medical Complex, Peshawar, KPK
  • MUHAMMAD ALI NOMAN Department of Neurosurgery, Hayatabad Medical Complex, Peshawar, KPK
  • SHAHID AYUB Department of Neurosurgery, Hayatabad Medical Complex, Peshawar, KPK
  • RIZWAN ULLAH KHATTAK Department of Neurosurgery, Hayatabad Medical Complex, Peshawar, KPK
  • MUSHTAQ . Department of Neurosurgery, Hayatabad Medical Complex, Peshawar, KPK
Keywords: Organized chronic subdural hematoma, Membranectomy

Abstract

Objective: This study presented the surgical outcome of craniotomy and membranectomy (outer membrane excision) for the organized Chronic Subdural Hematoma (OCSDH) which have already developed thick internal septations.
Materials and Methods: We retrospectively reviewed a series of consecutive patients operated via.craniotomy method for OCSDH in Neurosurgery Department Hayat Abad Medical Complex. Patients with both genders and all ages diagnosed as OCSDH with septae either diagnosed preoperatively via imaging CT/MRI or intraoperatively while getting operated by single burhole drain or two burhole wash method were enrolled in the study and operated via craniotomy/outer membranectomy method.  All data was recorded in pre-formed Performa and demographics, clinical data analysed to quantify outcomes statistically.
Results: Total 30 patients were operated in the 3 years study duration. Post-operative Recurrence of symptomatic hematoma was seen in only one patient, i.e. 3.33% and hence 29 (96.66%) had excellent outcome and remained symptom free at 6month followup visit. Out of 30 cases, we operated 27 (90%) were males and 3 (10%) were females, most of the cases were in the elderly age group (sixty five years was the mean age). Six cases (20%) had postoperative new onset seizures, all these patients were seizures free at 1month follow-up. Our three patients (10%) had a superficial wound infection.
Conclusion: Craniotomy and outer membranectomy is a safe procedure for the management of OCSDH offering good results and fewer/no recurrence, unless the adherent inner (cortical) membrane removal is attempted, which may result in new onset seizures and neurological deficits.

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Published
2019-06-04
Section
Original Article