gms | German Medical Science

Objective: Chronic subdural hematoma is a disease of underestimated importance. There are different modalities of surgical treatment described. We analyzed the impact of implantation of subdural drainage as well as of morphology of chronic subdural hematoma on postsurgical outcome.

Method: Between January 2007 and December 2011, 98 patients suffering from chronic subdural hematoma were treated in our Neurosurgical Intensive Care Unit. Demographic data, details on surgical technique, size / morphology of hematoma, Glasgow Coma Scale on admission and Glasgow Outcome Score on discharge were retrieved and retrospectively analyzed. Correlation coefficient test was used for statistical analysis. Correlation strength was expressed as r2. Significance was set at p <0.05.

Results: Overall mortality was 9.1%. There was an obvious correlation between Glasgow Coma Scale on admission and Glasgow Outcome Score on discharge (r2=0.4, p<0.001). The time-to-surgery correlated with better outcome (r2=0.21, p<0.05). There was no significant correlation between size of hematoma and Glasgow Outcome Score in analyzed group of patients. There was clear correlation between use of subdural drainage and improved outcome (r2=0.31, p<0.01).

Conclusions: Chronic subdural hematoma due to its high mortality rate is not a benign disease. The patients in good neurological condition on admission, who can be operated on in a scheduled manner have better chance of recovery. Proper surgical technique (insertion of subdural drainage) and not a hematoma size alone impacts the outcome in chronic subdural hematoma treatment.