Modified Nakaguchi Classification: Is it a New Way to Measure Outcome of Chronic Subrural Hematoma through GCOSE?

Authors

  • Muzafar Ali Bhand Department of Neurosurgery Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro
  • Sanaullaha Pathan Department of Neurosurgery Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro
  • Hameedullah Khan Department of Neurosurgery Indus Medical College, Tando Muhammad Khan – Pakistan
  • Peer Asad Aziz Department of Neurosurgery Bilawal Medical Collage, Jamshoro
  • Wafa Hyder Department of Internal Medicine, Sir Ganga Ram Hospital, Lahore
  • Arsalan Mehmood Department of Neurosurgery Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro
  • Zeeshan Nasir Department of Neurosurgery Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro

DOI:

https://doi.org/10.36552/pjns.v28i4.1052

Keywords:

Modified Nakaguchi classification, CSDH

Abstract

Objective:  The ? value of the Modified Nakaguchi classification is 0.78, the highest from other available classification systems for CSDH. The main objective of this study was to evaluate the outcome of CSDH concerning the type of CSDH according to the modified Nakaguchi classification.

Material and Methods:  It is a single cohort study conducted at Liaquat University Hospital Hyderabad and Jamshoro in the Neurosurgical Department. The patient's known case of chronic subdural hematoma was included in the study after evaluation of inclusion and exclusion criteria and variables like type of CSDH and GCS and GCOSE on discharge were noted on the pre-designed Questionnaire.

Results:  A total number of 63 patients were included in the study, with 69.8% being male and 30.2% female, and the overall mean age was 58.3 years. The most common presentation according to the Modified Nakaguchi Classification was Hypo-dense (30%) and Graded (27%) type. The mean pre-operative GCS was 10.98 and the post-operative GCS mean was 12.87 with a significance of 0.001. A total of 50.8% of patients had upper good recovery on Discharge GCOSE out of which 28.13% of Hypodense and Graded type. Total mortality was 22.2% out of which 28.6% was hypodense and Graded type respectively. The recurrence of CSDH was 11.1% and the most common type was Hypodense (57%).

Conclusion:  The Modified Nakaguchi Classification doesn’t define the outcome significantly, however, the surgical intervention related to its specific type is significantly associated with the outcome of the patient on the Glasgow coma outcome scale extended.

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Published

2024-12-31

Issue

Vol. 28 No. 4 (2024): October-December

Section

Original Articles

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Copyright (c) 2024 Muzafar Ali Bhand, Sanaullaha Pathan, Hameedullah Khan, Peer Asad Aziz, Wafa Hyder, Arsalan Mehmood, Zeeshan Nasir

The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).