Volume : 2, Issue : 7, JUL 2016

PATIENT PROFILE AND OUTCOME OF SUBDURAL HAEMATOMAS, A SINGLE CENTRE EXPERIENCE IN KENYA

Dr. Nasio A. Nasio

Abstract

A subdural haematoma (SDH) is a collection of blood between the dura matter and the arachnoid membrane. A prospective cross sectional descriptive study of all patients admitted with subdural haematoma as diagnosed on CT scan was conducted at the Nakuru level five hospital between 1st January 2015 and 30th November 2015. Four hundred and forty five patients were admitted with a diagnosis of head injury. Of these a total of sixty seven (67) patients were diagnosed on head CT Scan to have a subdural haematoma. There were sixty males and seven females with a male to female ratio of 8.6:1. The age ranged from three years to one hundred years with a mean of 43years (std 21.36.) The commonest causes of traumatic subdural haematoma in this subset of patients were falls and assault or violence related each at 25.4%. Sixty four percent (n=43) of the patients had mild head injury, 19 patients (28%) had moderate head injury while five patients (7.5%) had severe head injury. At discharge fifty one patients (76.1%) recorded a good recovery, five (7.5%) had varying degrees of disability while eleven patients died (16.4%). There is an important co relationship between the post non surgical resuscitation Glasgow coma score at admission and poor outcome (p<0.001). Likewise a history of loss of consciousness (p=0.031) and the presence of other associated injury (p=0.038) predicted a poor outcome.

Article : Download PDF

Cite This Article

Article No : 9

Number of Downloads : 699

References

1. Atkinson JL, Lane JI, Aksamit AJ. MRI depiction of chronic intradural (subdural)
hematoma in evolution. J Magn Reson Imaging. 2003 Apr. 17(4):484-6
2. Gennarelli TA, Thibault LE. Biomechanics of acute subdural hematoma. J Trauma.
1982 Aug. 22(8):680-6.
3. Izumihara A, Yamashita K, Murakami T. Acute subdural hematoma requiring surgery
in the subacute or chronic stage. Neurol Med Chir (Tokyo). 2013. 53(5):323-8.
4. Jennett B, Bond M. Assessment of outcome after severe brain damage. A practical
scale. Lancet 1975; 1:480—4
5. Kawakami Y, Chikama M, Tamiya T, Shimamura Y. Coagulation and fibrinolysis in
chronic subdural hematoma. Neurosurgery. 1989 Jul. 25(1):25-9
6. Kiboi J.G, Kitunguu P.K, Angwenyi P.O et al. outcome after acute traumatic subdural
haematoma in kenya: a single-centre experience. Africa journal of neurologic science
2010;29 (1)
7. Koc RK, Akdemir H, Oktem IS, et al. Acute subdural hematoma : outcome and outcome
prediction. Neurosurg Rev 1997; 20: 239-244.
8. Kotwica Z, Brzezinski J. Acute subdural haematoma in adults: an analysis of outcome
in comatose patients. Acta Neurochir (Wien). 1993. 121(3-4):95-9.
9. Kyu-Hong Kim. Predictors for Functional Recovery and Mortality of Surgically
Treated Traumatic Acute Subdural Hematomas in 256 Patients. J Korean Neurosurg
Soc 2009; 45: 143-150
10. Servadei F, Nasi MT, Giuliani G, et al. CT prognostic factors in acute subdural
haematomas: the value of the 'worst' CT scan. Br J Neurosurg. 2000 Apr. 14(2):110-6
11. Tamura R, Kuroshima Y, Nakamura Y. Neuroendoscopic Removal of Acute Subdural
Hematoma with Contusion: Advantages for Elderly Patients. Case Rep Neurol Med.
2016. 2016:2056190
12. Tian H, Chen S, Xu T et al. Risk factors related to hospital mortality in patients with isolated
traumatic acute subdural haematoma: analysis of 308 patients undergone surgery.
Chin Med J 2008; 121(12):1080-1084.
13. Tosaka M, Sakamoto K, Watanabe S, et al. Critical classification of craniostomy for
chronic subdural hematoma; safer technique for hematoma aspiration. Neurol Med
Chir (Tokyo). 2013. 53(4):273-8.
14. Van den Doel EM. Balzac's 'Pierette'. An early description of chronic subdural
hematoma. Arch Neurol. 1986 Dec. 43(12):1291-2
15. Wilberger JE Jr, Harris M, Diamond DL. Acute subdural hematoma: morbidity and mortality
related to timing of operative intervention. J Trauma. 1990 Jun. 30(6):733-6.