Factors influencing the outcome of patients with traumatic acute subdural hematoma (ASDH) – A single centre analysis

摘要

Head injury, one of the five major causes of death and disability globally, results in about 5 million deaths per year or 16 thousand deaths daily. The World Health Organization has stated the need for more research on the epidemiologic pattern of accidents in low and middle income countries to determine the dimensions of the problem. Severe traumatic brain injury (TBI) is accompanied by ASDH in approximately 60% of patients [1–5]. SDH is diagnosed on a CT scan as extra -axial, crescent shaped collection of blood between the dura and the brain parenchyma. They can be divided into hyper acute, acute, sub acute and chronic hematomas based on the time duration. We define “acute SDH” as SDH diagnosed within 72hrs of traumatic brain injury (TBI) [2].Re- ported mortality rates range from 36% to 79% for patients who undergo surgery for ASDH [3,4,6,7]. Many factors are believed to influence the outcome of ASDH patients including age, gender, GCS, intracranial pressure (ICP), pupillary size, response to hypoxia and computed to- mography (CT) findings [9–11].