gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Chronic subdural hematoma: Does size matter?

Meeting Abstract

  • Jacek Szczygielski - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar
  • Sina-Maria Gund - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar
  • Karsten Schwerdtfeger - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar
  • Joachim Oertel - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 037

doi: 10.3205/13dgnc456, urn:nbn:de:0183-13dgnc4568

Published: May 21, 2013

© 2013 Szczygielski et al.
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Outline

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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.