Abstract
Objective: To assess significant improvement in terms of the Glasgow Coma Scale in patients subjected to minimally invasive surgery for a chronic subdural hematoma.
 Materials and Methods: A total of 80 patients with chronic subdural hematoma (CSDH) were enrolled in a sequential fashion using a retrospective study design. The patients were treated with minimally invasive surgery (MIS) and assessed at the end of the 2nd postoperative day (POD) for any significant improvement in the Glasgow coma scale (GCS).
 Results: There were 76.25% male and 23.75% female patients. A maximum number of patients (42.5%) were found with a GCS ranging from 9/15 – 11/15 (Class B) followed by Class A having GCS 12-13 (36.25%) and then Class C with GCS 5 – 8 (21.25% patients). In 86.2% and 13.7& of the patients, positive and negative outcomes were recorded. Maximum favorable surgical outcome was observed in 51-60 years of age group. In the majority of male patients, a favorable surgical outcome was reported. Similarly, a favorable surgical outcome was observed in Class B (GCS 9-11). There existed an insignificant difference between favorable surgical outcome vs. age groups, gender, and GCS class at baseline.
 Conclusion: This study found that CSDH using the MIS approach is linked to a high frequency of positive outcomes in terms of GCS improvement. A lower admission GCS score and older age are linked to a lower frequency of favorable outcomes and a higher likelihood of bad outcomes.
Highlights
Chronic intracranial bleeding between the dura and arachnoid maters of the brain is known as chronic subdural hematoma (CSDH).[1]
A favorable surgical outcome was observed in Class B (GCS 9-11)
This study found that CSDH using the minimally invasive surgery (MIS) approach is linked to a high frequency of positive outcomes in terms of Glasgow coma scale (GCS) improvement
Summary
Chronic intracranial bleeding between the dura and arachnoid maters of the brain is known as CSDH.[1] It is a slowly increasing encapsulated collection of blood and its breakdown products generated by ripping of the bridging veins, which is most commonly caused by moderate head injury and has risk factors of brain atrophy and coagulopathy.The frequency is about 5/100,000 http//www.pakjns.org Pak. J. of Neurol. In 60 to 80 percent of patients, a minor head injury is observed to precede the onset of CSDH.[4] Chronic alcohol use, anti-platelet intake, and oral anticoagulation medication are all predisposing variables in 21% of cases, anti-platelet intake in 11%, and oral anticoagulant therapy in 10% of cases, respectively. Unilateral hematoma occurs in 82 percent of subjects, with the left side (57.2%) accounting for the bulk of instances, and bilateral distribution in 18 percent of patients.[5]
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