Acute Subdural Hematoma:Analysis of 183 Operated Cases

Lee, Kyeong Seok; Bae, Hack Gun; Yun, Il Gyu

Abstract

We present a series of 183 operated acute(within 24 hours) subdural hematomas from 1985 to 1991. All were diagnosed by computerized tomography. The primary causes of acute subdural hematoma were passenger's traffic accident(36.6%), pedestrian accident(31.7%), fall or slip(16.4%), and assaults(2.7%). A favorable outcome(good recovery and moderate disability) occurred in 31.7%, an unfavorable outcome(severe disability and vegetative state) in 11.5%, and a death resulted in 56.8% at discharge. Preoperative Glasgow Coma Scale score(GCS) and papillary status were major clinical predictors of prognosis. Age, sex, operative timing, severity of associated extracranial injury, and blood pressure on arrival did not significantly affect on the prognosis. As radiological predictors, degree of midline-shift, presence or absence of skull fracture, status of perimesencephalic cistern or third ventricle were significantly correlated with outcome. Size of the hematoma and presence or absence of combined intracranial focal lesions did not reflect a significant difference in the outcome.