Analysing Surgical Treatment for Patients with Chronic Subdural Haemorrhage (CSDH)
DOI:
https://doi.org/10.63682/jns.v13i1.8984Keywords:
Chronic subdural hematoma, burr hole drainage, neurosurgery, neurological recovery, subdural drain, postoperative outcomes, recurrence, elderly patientsAbstract
Background: Chronic subdural hematoma (CSDH) is common amongst elderly patients with neurosurgical disorders. Patients experience non-specific symptoms like headache, confusional state, or weakness in one side of the body which can result in a delay in diagnosis. Surgical evacuation, usually burr hole drainage, is the treatment of choice, but results are dependent on several clinical and radiological factors. To assess the demographic profile, presenting features, surgical management, and short-term outcomes in patients undergoing surgical treatment for chronic subdural haemorrhage.
Methods: A descriptive cross-sectional study was done at Hayatabad Medical Complex Hospital, Peshawar, where 83 patients with CSDH who underwent surgery were included from January 2023 to December 2023. Information on patient demographics, clinical symptoms, imaging studies, operative notes, and postoperative recovery was recorded. Results were evaluated based on the patient's neurological and functional recovery. For statistical analysis, SPSS version 26 was used and a significance level of p < 0.05 was applied.
Results: Most patients were male (73.5%) and aged 65 years or above (56.6%). Headache and altered mental status were the most common presenting complaints. Burr hole drainage was performed in 85.5% of cases, with subdural drains used in 79.5%. Neurological improvement was observed in 78.3% of patients, and 73.5% achieved good functional recovery (mRS ≤2). The recurrence rate requiring reoperation was 10.8%, while in-hospital mortality was 6%. Age, initial GCS, midline shift, and drain placement showed significant associations with outcomes.
Conclusion: Surgical treatment, particularly burr hole drainage with subdural drain placement, remains highly effective in managing CSDH. Favorable neurological and functional recovery was achieved in most patients, with low recurrence and mortality. Early diagnosis and timely intervention remain key to optimal outcomes
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References
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