Subdural hematomas: an analysis of 1181 Kashmiri patients

World Neurosurg. 2012 Jan;77(1):103-10. doi: 10.1016/j.wneu.2011.06.012.

Abstract

Background: We endeavored to analyze patients of subacute and chronic subdural hematomas studied in a 4-year period at the Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India.

Methods: The study was a retrospective analysis of 1181 patients of subdural hematomas. Demographic characteristics, clinico-radiologic features, operative modalities, and outcome were studied. Acute subdural hematomas were excluded from the study.

Results: The mean age was 60.4 ± 12.4 and males outnumbered females. Chronic subdural collections were more common than subacute subdural hematomas and left side predominated. Two burr holes with closed-system drainage was used in most patients. Incidence of postoperative seizures is very low. Overall recurrence rates were low; however, multilocular hematomas had the highest incidence of recurrence. Morbidity and mortality were 7.53% and 2.96%, respectively. Preoperative neurologic grade correlated with outcome.

Conclusions: Subdural hematomas are common in elderly males. Preoperative neurologic grade dictates the outcome. Multilocular hematomas have a higher chance of recurrence. Craniotomy should be reserved for recurrent hematomas, and there may be a scope of craniotomy for multilocular chronic subdural hematomas at the outset. Antiepileptic prophylaxis is not routinely recommended.

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use
  • Craniocerebral Trauma / complications
  • Craniotomy
  • Disease Susceptibility
  • Female
  • Follow-Up Studies
  • Functional Laterality / physiology
  • Hematoma, Subdural / diagnostic imaging
  • Hematoma, Subdural / epidemiology
  • Hematoma, Subdural / surgery*
  • Hematoma, Subdural, Chronic / diagnostic imaging
  • Hematoma, Subdural, Chronic / epidemiology
  • Hematoma, Subdural, Chronic / surgery
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Nervous System Diseases / etiology
  • Neurosurgical Procedures
  • Postoperative Care
  • Postoperative Complications / epidemiology
  • Postoperative Complications / therapy
  • Recurrence
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anticoagulants