Abstract

Aim: To determine the functional outcome of acute subdural hematoma managed surgically.

Study Design: Prospective study

Place and Duration: Department of Neurosurgery, PGMI Lady Reading Hospital Peshawar. Duration of the study was four years (from 9th December 2014 to 8th Dec 2018)

Material and methods: One hundred and forty seven patients of both genders presented with acute subdural hematoma were enrolled in this study. Informed consent was taken from all patients. These patients were further assessed through detailed history, including personal particulars, name, age, sex, address, mechanism of injury, symptoms and clinical examination, time since injury, initial Glasgow coma scale (GCS) score. Diagnosis of acute subdural hematoma (ASDH) was made on the basis of CT brain and per-op findings. The patient were followed post operatively till discharge from the hospital and were assessed by a Neurosurgeon for any morbidity or mortality in term of Glasgow outcome score (GOS) after one month, 3 months and 6 months and then categorized either in the functional recovery or nonfunctional recovery groups. All the observation and examination recorded in a predesigned Performa.

Results: Mean age was 31.34 years with SD ± 1.49. Our study shows 47(32%) patients were in age range < 20 years, 59 (40.1%) in age range 21-40 years, and 41(27.9%) were in age range 41-60 years. Male are more involved in this type of injury (68.7%) and 46(31.3%) were females. GOS were 1 for 51% (n-75) patients, 27% (n-40) patients had GOS score 2-3 and 22% (n-22) patients had GOS score 4-5. Thirty two (22%) patients had functional recovery (GOS 4-5) while 115(78%) patients didn’t have functional recovery (1-3).

Conclusion: Functional recovery of the surgically managed acute subdural hematoma was 22% in our study. Functional outcome of traumatic brain injury with subdural hematoma is multifactorial and timely surgical intervention can make functional recovery more favorable.

Keywords: Acute subdural hematoma, Traumatic brain injury, Glasgow outcome score