Prognostic Factors and Their Effects on Mortality in Traumatic Acute Subdural Haematoma

Abstract

Objective: To present our series of 37 cases of traumatic acute subdural hematoma (ASDH) with regard to their prognostic factors and characteristics affecting mortality in Dr. Muhittin Ülker Emergency Traumatology and Research Hospital Neurosurgical Clinic between 1998-2003.


Methods: Hospital records were reviewed with regard to age, gender, types of trauma, time to surgery, Glasgow Coma Score (GCS), other systemic injuries which require surgical intervention, localisation, additional cerebral pathologies and operation types.

Results: 59,5% of the cases were male, 40,5% of the cases were female and average age was 49,6 (range 8-77). The most frequent cause was traffic accidents. The most frequent location was frontotemporoparietal (43,2%). Midline shift was present in 94,5% of the cases. Preoperative GCS score was 8 or less in 64,8 % of the cases. Mortality was significantly higher in this group (p<0.0001). The most frequent pathology accompanying ASDH was hemorrhagic contusion (35,1%). 32% of the cases were operated within the first four hours. Mortality rate in this group was significantly lower (p=0.009). Overall, 32.4 % of the patients had a good outcome.

Conclusion: Traumatic acute subdural haematoma is a very serious health problem with very high mortality and morbidity rates. Early surgical intervention within four hours improves outcome.