Elsevier

Surgical Neurology

Volume 40, Issue 1, July 1993, Pages 22-25
Surgical Neurology

Outcome and outcome prediction in acute subdural hematoma

https://doi.org/10.1016/0090-3019(93)90164-VGet rights and content

Abstract

This study is based on a series of 109 consecutive head injured patients with the CT scan diagnosis of acute subdural hematoma. The overall outcome was assessed at 6 months after injury using the Glasgow Outcome Scale. By logistic regression analysis a small set of clinical features (the best sum Glasgow Coma Scale score within 24 h after admission, and pupillary inequality) was revealed as significant prognostic features. The method described allows bedside predictions in individual future cases.

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      The prognosis of aSDH is influenced by multiple factors such as age; Glasgow Coma Scale (GCS); pupillary inequality; computed tomography (CT) findings (hematoma size, midline shift, associated intradural lesion, compression of basal cisterns); and time until surgical treatment. However, the occurrence of seizures was described as an independent prognostic factor for unfavorable outcome.2,4-7,3 Therefore it is crucial to identify and treat high-risk patients as soon as possible.

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      In particular, injuries involving SDHs are likely to increase both ePTSs and lPTSs in children and adults compared to other TBIs [3]. The prognosis after an SDH depends on multiple factors such as age, Glasgow coma scale (GCS), size of haemorrhage and time from the SDH until treatment, but the occurrence of a PTS is an independent marker of poor functional and social outcome [5–8,10,19]. Antiepileptic drugs (AEDs) are standard treatment for lPTSs, but their use in ePTSs remains controversial.

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