[Surgical outcome of 32 cases in traumatic subdural hygroma]

32 cases of traumatic subdural hygroma (TSH) in adults with surgical treatment were retrospectively investigated by means by clinical features and CT findings. The cases consisted of 29 males and 3 females, aged 41 to 87 years (mean 69). Preparative CT scan of all cases revealed low density area and crescent shape in frontotemporal or frontoparietal subdural space. Half of the cases had bilateral lesions. At operation of TSH, color of subdural fluid collections was more water clear or xanthochromic than bloody. As a results, 22 out of 32 cases (69%) in TSH improved with surgical treatment. Many of effective cases of surgical treatment in TSH had short interval from trauma to operation and light disturbance of consciousness before operation. However, the other intracranial damage will also affect the clinical outcome of TSH, because the majority of cases in this study was accompanied by an intracranial damage including cerebral contusion, subarachnoid hemorrhage or intracranial hemorrhage. Nevertheless, surgical management for TSH was so effective that the operation should be undergone sooner interval from trauma, simultaneously considering the another intracranial lesions except TSH. But then, we experienced 7 cases (22%) of ventricular dilatation and 5 cases (16%) of chronic subdural hematoma in postoperative follow up CT scans. In 5 cases among the former, ventriculoperitonial shunt was done, and in 3 cases among the latter, burr hole evacuation was performed. Therefore, the postoperative course of TSH should require careful observation by CT scan and so on.