Minimal Invasive Surgery for Chronic Subdural Hematoma

  • Hanif-ur- Rahman Department of Neurosurgery, Hayatabad Medical Complex, MTI (Medical Teaching Institute), Peshawar, Pakistan.
  • Sohail Amir Department of Neurosurgery, Hayatabad Medical Complex, MTI (Medical Teaching Institute), Peshawar, Pakistan.
  • Mumtaz Ali
  • Shahid Ayub
  • Anisa Sundal Rehman Medical Institute, Peshawar, Pakistan.
  • Muhammad Ishaq Mardan Medical Complex, Peshawar, Pakistan.
Keywords: Glasgow Coma Scale, Chronic Subdural Hematoma, Minimal Invasive Surgery.


Objective:  To assess significant improvement in terms of the Glasgow Coma Scale in patients subjected to minimally invasive surgery for a chronic subdural hematoma.

Materials and Methods:  A total of 80 patients with chronic subdural hematoma (CSDH) were enrolled in a sequential fashion using a retrospective study design. The patients were treated with minimally invasive surgery (MIS) and assessed at the end of the 2nd postoperative day (POD) for any significant improvement in the Glasgow coma scale (GCS).

Results:  There were 76.25% male and 23.75% female patients. A maximum number of patients (42.5%) were found with a GCS ranging from 9/15 – 11/15 (Class B) followed by Class A having GCS 12-13 (36.25%) and then Class C with GCS 5 – 8 (21.25% patients). In 86.2% and 13.7& of the patients, positive and negative outcomes were recorded. Maximum favorable surgical outcome was observed in 51-60 years of age group. In the majority of male patients, a favorable surgical outcome was reported. Similarly, a favorable surgical outcome was observed in Class B (GCS 9-11). There existed an insignificant difference between favorable surgical outcome vs. age groups, gender, and GCS class at baseline.

Conclusion:  This study found that CSDH using the MIS approach is linked to a high frequency of positive outcomes in terms of GCS improvement. A lower admission GCS score and older age are linked to a lower frequency of favorable outcomes and a higher likelihood of bad outcomes.


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