Outcome of Surgical Management of Chronic Subdural Hematoma

Authors

  • NAQIB ULLAH ACHAKZAI Department of Neurosurgery, Bolan Medical College/ Sandeman Provincial Teaching Hospital, Quetta 87300 Pakistan
  • Irfan Adil Department of Neurosurgery, Bolan Medical College/ Sandeman Provincial Teaching Hospital, Quetta 87300 Pakistan
  • Saleem Khan Department of Neurosurgery, Bolan Medical College/ Sandeman Provincial Teaching Hospital, Quetta 87300 Pakistan

Keywords:

Chronic Subdural Hematoma, Markwalders Grading, Recurrence, Glasgow Outcome Scale

Abstract

Objective: To determine outcome of surgical management of Chronic Subdural Hematoma.
Study Design: Descriptive Study.
Materials and Methods: Patients with Chronic Subdural Hematoma diagnosed on CT scan brain admitted to the Neurosurgery Department, Bolan Medical College/Hospital, Quetta Pakistan from January 2008 to December 2017. Patients included in the study were those who presented with CSDH only and all those patients were excluded who had undergone surgery previously elsewhere. At the time of admission the neurological status was classified according to a Grading Scheme which was proposed by Markwalder et al. Radiological evaluation was done by CT Scan before surgery and routine CT Scan of each patient was done one day after surgical inter-vention, one week after and anytime if required. Outcome was determined by GCS and GOS. Good Recovery and Moderate Disability were considered as favorable outcome while Severe Disability, Persistent Vegetative State and Death as unfavourable outcome.
Data Analysis: SPSS software was used for data analysis.
Results: A total of 145 patients were treated with surgical evacuation of CSDH. 121 (83%) patients were men while 24 (17%) were women with Male to Female ratio of 5:1.10 (7%) patients had Markwalders Grade 1, 57 (39%) had Markwalders Grade 2 while 46 (32%) patients had Grade 3 and 32 (22%) had Grade 4. Recurrence occurred in 20 (14%) patients. 129 (89%) patients had favourable outcome while 16 (11%) had unfavourable outcome.
Conclusion: The favourable outcome of surgical evacuation of Chronic Subdural Hematoma is quite high if operated early. Moreover, the course and outcome is affected by several factors particularly the initial neurological status at the time of diagnosis.

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Published

2018-06-30

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Vol. 22 No. 2 (2018): April-June

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Original Articles

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