Background: Acute subdural hematoma is a lesion caused by traumatic brain injury. Computed topography, hematoma thickness and midline shift analysis are important factors in evaluating its prognosis.

Aim: To evaluate the factors involved in prognosis of acute subdural hematoma.

Study design: Retrospective study

Place and duration of study: Department of Neurosurgery, Chandka Medical College Hospital, Larkana from 1^st October 2020 to 30^the June 2021.

Methodology: One hundred patients from both genders and between age 18-55 years were enrolled. Clinical examination and radiological complete examination was done in each patient. Zumkeller Index (ZI) was calculated and Glasgow scoring was performed.

Results: The mean age were 44.1±15.8 years with 87% males having major reasoning of head injury as a motor cycle accident. Traumatic brain injury was recorded as >3mm ZI in 10 cases. The mean midline shift was 12.4±6.06 mm with a significant difference between three categories.

Conclusion: Midline shift and hematoma thickness are useful predictors of prognosis related to acute subdural hematoma.

Keywords: Prognostic factor, Acute subdural hematoma, Computed tomography (CT)