Does Concomitant Epidural Hemorrhage and/or Traumatic Intracerebral Hemorrhage Influences on Outcome of Surgically Treated Acute Subdural Hemorrhage (SDH) Patient?

Abstract

Objective: In order to present statistical evaluation on the prognosis and surgical outcome of acute subdural hemorrhage (SDH), and concomitant epidural hemorrhage (EDH) and/or concomitant traumatic intracerebral hemorrage (T-ICH), we report the analysis of clinical findings and treatment results with literature. Methods: We retrospectively analyzed for 71 cases of 466 acute SDH cases that treated in Gyeoungsang National University Hospital from January 2006 to December 2008 by medical record. We analysed the age, gender, initial Glasgow Coma Scale (GCS) on admission, pupil light reflex, the time from emergency room to operation room, according to pastient’s Glasgow Outcome Scale (GOS). We used computed tomography (CT) scan to investigate the presence of concomitant EDH, T-ICH, presence of midline shifting. hemorrhage depth. We also took interest in effect of location of concomitant hemorrhage on patient's GOS. Results: There was stastistically significant correlation the age, GCS, pupil light reflex, concomitant bilateral hemorrhage unrelated with subtype with patient’s outcome (GOS) but other’s parameters (midline shifting, the time from emergency room to operation room) have no statistical significance correlation with patient’s outcome. Conclusion: This study showed that the factors like age, GCS on admission, and pupil light reflex were related to the prognosis of the patients with acute SDH, and involving bilateral hemorrhage, instead of unilateral, illustrated outcomes in any type of intracranial hemorrhage. We think that a futher study would be performed that includes amount of hemorrhage, location of hemorrhage, and a larger number of patients for statistical plausibility. (J Kor Neurotraumatol Soc 2010;6:27-32)