Spectrum of Clinical Presentation and Surgical Outcome in Patients with Chronic Subdural Haemorrhage: A Retrospective Study
Introduction: Chronic subdural haematomas are one among common neurosurgical emergencies especially affecting elderly male. Usually, presents with subacute Cerebro Vascular Accident (CVA), impaired higher mental function and sometimes with reversible dementia. Rarely, it presents with end stage...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-03-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14671/47067_CE[Ra1]_F[SK]_PF1(AB_SL)_PFA(KM_AB_SL)_PN(SHU).pdf |
| Summary: | Introduction: Chronic subdural haematomas are one among
common neurosurgical emergencies especially affecting elderly
male. Usually, presents with subacute Cerebro Vascular Accident
(CVA), impaired higher mental function and sometimes with
reversible dementia. Rarely, it presents with end stage herniation.
Burr Hole Drainage (BHD) is the most popular and worldwide
procedure of choice and it successfully address the problem in
majority of cases. However, in a small group of patients it needs
a wider craniotomy to deal with the subdural membrane which is
mainly associated with recurrence of the entity.
Aim: To evaluate the comparative incidence of various clinical
presentation and analysing the outcome of different treatment
modalities in different subgroups of patients with chronic subdural
haemorrhage with respect to complication and survivality.
Materials and Methods: This retrospective study enrolled data
of 100 consecutive patients of subacute (n=30) and chronic
subdural haematoma (n=70) who were admitted and undergone
neurosurgical management of Veer Surendra Sai Institute of
Medical Science and Research (VIMSAR), Burla, Odisha between
September 2018 to September 2020. Variables were collected
from patient’s records at discharge and analysed with respect
to spectrum of clinical presentation and surgical outcome of
different treatment modalities and problems associated with it.
Results: The mean age group was 57.39 years and headache
was the most common clinical presentation in the present study
(86%) followed by hemiparasis (74%). BHD was carried out in
94 patients (94%). Primary craniotomy and membrane excision
was carried out in 5 patients. Secondary craniotomy was
performed in 1 patient after early re-accumulation and clinical
deterioration. The outcome was assessed utilising Glasgow
outcome scale with total five deaths in the series.
Conclusion: Chronic Subdural Haemorrhage (CSDH) a problem
of late adulthood (5th to 6th decade) which mostly follows two
to three weeks after trauma. It needs proper preoperative
assessment and requires timely intervention with skilled nursing
care for early recovery. Post-traumatic subacute subdural
haematoma in young subject and alcoholics needs special
attention during course of their treatment. Bilateral puppilary
failure, low Glasgow Coma Scale (GCS) and seizure association
are risk factors for poor outcome. |
|---|---|
| ISSN: | 2249-782X 0973-709X |