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  • Clinical Aspects in the Treatment of Traumatic Acute Subdural Hematoma: Report on 250 Patients

    Final Number:

    Wellingson S. Paiva MD, PhD; Almir F. Andrade MD, PhD; Nadia Nader Mangini PhD; Eberval G. Figueiredo MD, PhD; Mauricio Mandel MD; Robson Luis Amorim MD; Manoel Teixeira

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2011 Annual Meeting

    Introduction: Acute subdural hematoma (ASDH) occurs in about 1-5% of all traumas to the skull, and in 22% of traumatic brain injury (TBI). Despite all the improvements in conditions of care, ASDH remains one of the most lethal traumatic pathologies. In this study described the evolution of 250 patients with diagnosis of subdural hematoma and discuss prognostic factors

    Methods: All patients with CT diagnosis of acute subdural hematoma and who were hospitalized survived resuscitative measures in the emergency room were considered in this prospective study. This period have been raised a total of 250 patients. Were studies through systematic care protocol epidemiological, clinical and radiological aspects of these patients.

    Results: Subdural hematomas accounted for 23% of all hospitalized TBI in period of study. Patients were predominantly male (76%), aged 15 and 81 years, being the predominant cause falls (46%) followed by traffic accidents (28%). Related to clinical severity, we verified mild TBI 30 (23%) moderate 26 (20%) severe 76 (67%). In the evaluation of injuries associated we verified brain swelling like intracranial injuries more frequent. The surgery was performed in 45.1% of patients, and mostly by craniotomy fronto-temporo-parietal, with evacuation of the hematoma. Were operated a total of 132 patients underwent surgical treatment, with the lethality rate of 38% in cases operated and 23% in cases not operated. Patients not operated were in better initial clinical condition in hospital admission. patients victims of motorcycle accident had worse prognosis compared with other groups

    Conclusions: It is important to serious injury, with high mortality. surgical treatment was often need. We observed a decrease in mortality compared with other series in the same service in another period.

    Patient Care: identify epidemiological aspects of severity in patients with subdural hematoma;

    Learning Objectives: 1) Describe the importance of surgical treatment to subdural hematoma, 2) Discuss literature about this severe condition, prognosis and epidemiological aspects, 3) Identify prognostic factors in this disease

    References: Kim KH.Predictors for functional recovery and mortality of surgically treated traumatic acute subdural hematomas in 256 patients.J Korean Neurosurg Soc. 2009;45(3):143-50. Sawauchi S, Abe T. The effect of haematoma, brain injury, and secondary insult on brain swelling in traumatic acute subdural haemorrhage. Acta Neurochir (Wien). 2008;150(6):531-6

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