Volume: 43 Issue: Supplementary 1
Year: 2023, Page: 196-200, Doi: https://doi.org/10.51248/.v43i1.2461
Introduction and Aim: The most common intracranial injury was subdural hematoma (SDH). In this study, as a primary objective, we evaluated the association between the timing of surgical evacuation in patients with SDH and the functional outcome. The secondary objective is to identify prognostic factors associated with poor outcomes in patients with SDH.
Methods: This is a retrospective study of medical records from the injury registry of patients with traumatic brain injury (TBI). The patients were divided into three groups according to their assessment by the Glasgow coma scale scores: mild TBI (13 to 15), moderate TBI (9 to 12), and severe TBI (3 to 8).
Results: The average age of the studied population was 49.8 ± 19.7 years, there were 77.2% of male patients in the study population. In terms of severity, 63.4% of patients had severe head injuries, while 17.9% had mild head injuries. The average severity of the damage was 25.5 ± 5.7 and the low score on the Glasgow coma scale was 4.7 ± 0.4.
Conclusion: Signs of a compressed brainstem are strong prognostic factors in predicting the functional outcome in patients with acute SDH who underwent surgery.
Keywords: Subdural hematoma; traumatic brain injury; Glasgow coma scale; Glasgow outcome scale; intensive care unit.
1. Walcott, B. P., Khanna, A., Kwon, C. S., Phillips, H. W., Nahed, B. V., Coumans, J. V. Time interval to surgery and outcomes following the surgical treatment of acute traumatic subdural hematoma. J Clin Neurosci. 2014;21(12):2107-2111.
2. Vathanalaoha, K., Oearsakul, T., Tunthanathip, T. Predictive Factors of Survival and 6-Month Favorable Outcome of Very Severe Head Trauma Patients; a Historical Cohort Study. Emerg (Tehran). 2017;5(1): e24.
3. Tunthanathip, T., Phuenpathom, N. Impact of road traffic injury to pediatric traumatic brain injury in Southern Thailand. J Neurosci Rural Pract. 2017;8(4):601-608.
4. Selladurai, B. M., Jayakumar, R., Tan, Y. Y., Low, H. C. Outcome prediction in early management of severe head injury: An experience in Malaysia. Br J Neurosurg. 1992;6(6):549-557.
5. Sakas, D. E., Bullock, M. R., Teasdale, G. M. One-year outcome following craniotomy for traumatic hematoma in patients with fixed dilated pupils. J Neurosurg. 1995;82(6):961-965.
6. Phuenpathom, N., Tiensuwan, M., Ratanalert, S., Saeheng, S., Sripairojkul, B. The changing pattern of head injury in Thailand. J Clin Neurosci. 2000;7(3):223-225.
7. Mauritz, W., Leitgeb, J., Wilbacher, I., Majdan, M., Janciak, I., Brazinova, A., et al., Outcome of brain trauma patients who have a Glasgow coma scale score of 3 and bilateral fixed and dilated pupils in the field. Eur J Emerg Med. 2009;16(3):153-158.
8. Mann, C. J. Observational research methods. Research design II: Cohort, cross sectional, and case-control studies. Emerg Med J. 2003;20(1):54-60.
9. Maas, A. I., Steyerberg, E. W., Butcher, I., Dammers, R., Lu, J., Marmarou, A., Mushkudiani, N. A., et al., Prognostic value of computerized tomography scan characteristics in traumatic brain injury: Results from the IMPACT study. J Neurotrauma. 2007;24(2):303-314.
10. Lieberman, J. D., Pasquale, M. D., Garcia, R., Cipolle, M. D., Mark Li, P., Wasser, T. E. Use of admission Glasgow coma score, pupil size, and pupil reactivity to determine outcome for trauma patients. J Trauma. 2003;55(3):437-442.
11. Karibe, H., Hayashi, T., Hirano, T., Kameyama, M., Nakagawa, A., Tominaga, T. Surgical management of traumatic acute subdural hematoma in adults: A review. Neurol Med Chir (Tokyo). 2014;54(11):887-894.
12. Hatashita, S., Koga, N., Hosaka, Y., Takagi, S. Acute subdural hematoma: Severity of injury, surgical intervention, and mortality. Neurol Med Chir (Tokyo). 1993;33(1):13-18.
13. Dent, D. L., Croce, M. A., Menke, P. G., Young, B. H., Hinson, M. S., Kudsk, K. A., et al., Prognostic factors after acute subdural hematoma. J Trauma. 1995;39(1):36-42.
14. Bullock, M. R., Chesnut, R., Ghajar, J., Gordon, D., Hartl, R., Newell, D. W., et al., Surgical management of acute subdural hematomas. Neurosurgery. 2006;58(3 Suppl): S16-iv.
15. Brazinova, A., Mauritz, W., Leitgeb, J., Wilbacher, I., Majdan, M., Janciak, I., et al., Outcomes of patients with severe traumatic brain injury who have Glasgow coma scale scores of 3 or 4 and are over 65 years old. J Neurotrauma. 2010;27(9):1549-1555.
Keneshbek Yrysov, Kursanbek Kalyev, Mitalip Mamytov, Beksultan Yrysov, Bakytbek Turganbaev. Optimal timing of surgical intervention in acute subdural hematoma. Biomedicine: 2023; 43(1) Supplementary issue: 196-200