Clinical Presentation and Postoperative Outcome in Patients with Chronic Subdural Hematoma
Keywords:
Chronic subdural hematoma,, C.T. scan, Burr-hole craniostomy.Abstract
Objective was to study the clinical features of chronic subdural hematoma and Postoperative outcome after one week of surgery in chronic subdural hematoma. It was a descriptive study. It was a hospital based study which was conducted in the department of neurosurgery at PIMS; from 1st July 2002 to 30th June 2003.Thirty patients of chronic subdural hematoma were included in this study. This study was conducted on thirty patients suffering from chronic subdural hematoma. These patients were selected on the basis of history, clinical features and C.T. scan or M.R.I. findings, showing the evidence of chronic subdural hematoma. For data analysis, spss 8 software was used.
Results: Thirty patients were studied. Among them, there were twenty four male patients and six female patients. The male to female ratio was 4:1. The age range was 40 to 88 with average of 61 years. Twenty one patients (70%) gave a history of head injury. Nine patients (30%) did not remember any injury to the head. Twenty two patients (73%) had hemipresis. Twenty patients (66%) presented with headache. Seventeen patients (56%) had a history of bed wetting. Fourteen patients (47%) presented with behavioral changes. CT scan of twenty three (76.6%) patients showed unilateral hematoma while the remaining seven (23.3%) showed bilateral chronic subdural hematoma. Twenty eight were operated under general anesthesia while the rest were operated under local anesthesia. On discharge twenty six 86.6% patients showed excellent outcome. Mortality rate was 6.6%.
Conclusion: Chronic subdural hematoma is an important reversible cause of disability in the elderly. Most of them present with hemipresis, headache, and urinary incontinence. While some of them present with behavioral changes and memory loss. When patients were followed after one week of surgery it was found that most of them had an excellent outcome. Mortality and morbidity of chronic subdural hematoma has decreased markedly in recent years because of improved diagnostic facilities and prompt surgical intervention.
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