Subdural haematoma: an evaluation of treatment methods

Several methods of treatment, both surgical and conservative have been tried for subdural haematoma. No single method is perhaps applicable to all the cases and an individualised treatment is necessary. This review comprising 100 patients of which 26 with subacute and 74 with chronic subdural haematoma attempts to evaluate the experience with different surgical techniques at one centre in order to highlight some guiding principles in the treatment. There were 91 males and 9 females. Thirty patients had right sided, 52 had left sided and 18 had bilateral haematomas. So in a total of 118 haematomas, 84 were initially treated by twist-drill craniotomy, 9 with burr-hole operation and 8 with craniotomy. Seventeen patients were treated conservatively without any surgical intervention. The stepwise escalation (twist-drill, burr-hole and then craniotomy) in surgical procedures were adopted in failure cases, the simpler procedure being followed by more severe ones. Six patients died in this series. Fifty-one patients were followed up to a period of one year with a recurrence in 9 cases. Seven patients with a follow-up for 2 years and 3 patients up to 2-4 years had no recurrence detected.