Acute subdural hematomas. Review of 144 cases.

Area of Science:

• Neurosurgery
• Trauma Surgery
• Neurology

Background:

• Acute subdural hematomas (ASDH) are a common consequence of severe closed head injuries.
• Surgical intervention is often necessary to manage the increased intracranial pressure and prevent secondary brain damage.

Purpose of the Study:

• To analyze the outcomes of surgically treated acute subdural hematomas.
• To evaluate the impact of treatment timing and surgical techniques on mortality and patient recovery.

Main Methods:

• Retrospective review of 144 patients with surgically treated acute subdural hematomas.
• Analysis of mortality rates based on time to surgical intervention (within 24 vs. 72 hours).
• Comparison of outcomes between different surgical approaches (burr holes/subtemporal craniectomy vs. large craniotomy) and patient age groups.

Main Results:

• Overall mortality rate was significant, with 48% for treatment within 24 hours and 45% within 72 hours.
• Mortality was markedly higher in patients over 60 years (69%) compared to those under 10 (33%).
• Surgical approach showed minimal difference in mortality (41% vs. 45% for older vs. newer techniques).

Conclusions:

• Surgical management of acute subdural hematomas following head injury is associated with substantial mortality.
• Patient age is a critical prognostic factor, with elderly individuals facing significantly worse outcomes.
• While surgical techniques have evolved, outcomes remain challenging, highlighting the need for improved treatment strategies.