Etiology and Surgical outcome of chronic Subdural hematoma at Tertiary Care Hospital.

Abstract

Objectives: To determine etiology and management outcome among patients presenting with chronic subdural hematoma at tertiary care Hospital. Study Design: Cross Sectional. Setting: Department of neurosurgery, Liaquat University Hospital, Hyderabad/Jamshoro. Period: One year from 2015 to 2016. Material & Methods: All the patients with diagnosis of unilateral chronic subdural hematoma, and both male and female gender were included in this study. CT scan and other relevant laboratory investigations were done. All the patients underwent treatment of burr hole evacuation after taken informed consent. Antibiotics were given to all the patients pre- and post-operatively. All the subjects underwent CT scan for the evaluation of hematoma cavity. Patients were discharged generally following 1-week and were followed at outpatients department for 1-month, 3-months and 3-months, respectively. All the patients were assessed according to Glasgow Outcome Scale. Results: Over a period of one year; total thirty patients were selected, most of them were in the 6^th and 7^th decades of their lives and males were in majority 25(83%). Sixteen patients had a history of minor head injury, eleven patients had no obvious cause and one patient had chronic subdural hematoma secondary to over shunting. According to complications; intracerebral bleed was among 2(6%) cases and Pneumocephalus was in 2(6%) cases, followed by subdural empyema, acute subdural hematoma, extra dural hematoma, penetration into brain via drain catheter, C.S.F leakage and dysphasia were found in one patient, in each case, respectively. Almost every patient recovered and survival rate was 28(93%), while only two patients died. Conclusion: It was concluded that patients showed best outcome (93% survival rate) according to Glasgow Outcome Scale, after burr hole evacuation management. Head injury due to road traffic accident was the most common etiology and burr hole evacuation was the best treatment option for chronic subdural hematoma.