gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

The acute and subacute subdural hematoma: a retrospective analysis of 274 patients focusing on new aspects in epidemiology

Das akute und subakute Subduralhämatom: eine retrospektive Auswertung von 274 Patienten unter besonderer Berücksichtigung neuer Aspekte der Epidemiologie

Meeting Abstract

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  • corresponding author L. Dörner - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • S. Eifrig - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • H. Barth - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • H. M. Mehdorn - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP059

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0327.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Dörner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The acute subdural hematoma is known for its poor prognosis. The usual pathophysiology is a severe head trauma with parenchymal injury. In literature motor vehicle accidents have been described as the major cause.

The aim of this study was to check if these conclusions are still applicable in modern times. The widely used airbags and improved medical care might improve outcome.

Methods

Retrospectively we analyzed 274 patients. We saw in our hospital over the last 10 years from 1994 up to 2003. The mean age was 58 years with peaks in the sixth and eight decade; the gender ratio was 198 male to 76 female. 185 patients were secondary or tertiary referrals.

Results

109 patients died or were discharged with a GOS of less than 3. This accounts for 40% poor results in our patient group. 40% of the traumas were secondary to alcohol consumption. The outcome is significantly dependant on the midline shift and parenchymal trauma and not on the thickness of the hematoma, especially in the geriatric patient. In only 10 % of the traumas the patients were driving in a car. In traffic accidents pedestrians and cyclists are now the patients with most acute subdural hematomas. In several of the cases concerning automobiles there was no air bag or the patients had no fastened seat belt.

Conclusions

The outcome of patients with acute and subacute subdural hematoma is still poor but has improved compared to the published data of the 1980's. It is primarily dependent on the midline shift seen as the midline shift in diagnostic imaging. The widespread equipment with airbags and the use of seat belts has reduced the head traumas in motor vehicle accidents. Hopefully the use of helmets for cyclists will further lower the numbers. Domestic accidents especially after consumption of alcohol are now the major cause of severe head traumas with acute subdural hematomas.