РЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ КРИТЕРИЕВ ШКАЛЫ ОЦЕНКИ ПРИ ОСТРЫХ МАЛЫХ СУБДУРАЛЬНЫХ ГЕМАТОМ

Abstract

The purpose of the study: to determine the criteria for the assessment of acute small subdural hematomas for the subsequent treatment of intracranial subdural hematomas of small volume. Methods. A retrospective analysis was carried out, as well as an assessment according to the criteria of a unified scale of 210 patients from March 2018 to December 2020 in the Department of Emergency Neurosurgery of Central railway hospital in Astana with acute small subdural hematomas, including patients with indications for a certain type of surgery. Results. In 123 patients, after conservative treatment, according to CT of the brain, complete resorption of the hematoma was observed within up to 10 days. In 63 cases, it was possible to transform an acute hematoma into a chronic form and subsequently apply minimally invasive tactics (closed external drainage of the hematoma). 29 patients, due to the negative dynamics on the background of drug treatment, underwent osteoplastic trepanation with the removal of the hematoma within 3-4 days. Based on the data, a unified scale was developed, which sets out the criteria for determining the tactics of treatment “Scale for assessing hematomas of acute small subdural hematomas”. Conclusions. A unified scale is presented for determining the tactics of treating acute subdural hematomas of small volume, based on clinical and expectant management, which allows expanding the indications for minimally invasive treatment or refusal of surgical treatment to complete resorption of the hematoma based on an in-depth understanding of the pathogenesis of subdural hematomas.