Title: Chronic Subdural Hematoma: A Comprehensive and Analytical Study in a Tertiary Care Teaching Hospital of Vindhya Region of India
Authors: Dr Ashok Nayak, Dr Vinod Yedalwar, Dr Lalmani Singh, Dr Rajeev Kaneria, Dr Ajay Sharma
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.23
Abstract
Objective: To correlate the etiological factors, to confirm the diagnosis, role of surgical intervention and effect on outcome of these patients.
Material and Method: A Prospective study of 42 cases of chronic subdural hematoma was conducted in surgical wards of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital Rewa during 2013-2017. After admission, detailed clinical and neurological assessment done with routine and specialized investigation. Diagnosis confirmed by CT/MRI and surgical intervention done. Assessment of outcome done by Markwalder Grading System (MGS) at admission and in postoperative period.
Results: Forty-two patients of chronic subdural hematoma were treated in our department during the study period. 76.18% patients were above the age of 60, 85.71% patients had history of trauma 4-8 weeks back, most Common Presenting symptom was Headache(85.71%), and drowsiness (76.19%), Overall, there was a significant improvement in the neurological status of patients from admission to follow-up in patients grouped in MGS score 2. The mortality rate in our study was 7.7%.
Conclusion: Present study gives an epidemiological overview of this surgical condition, role of detailed neurological assessment and appropriate surgical intervention. In our study we found that 30 out of 32 patients that belonged to moderate neurological impairment group( MGS-2) showed significant improvement in neurological status postoperatively and had a post op MGS of 0-1. Based on this observation we can conclude that there is strong evidence in favor of timely and appropriate surgical intervention in treatment of CSDH, so as to reduce morbidity and mortality associated with the disease.
Keywords: Hematoma, Chronic, Subdural, Neurosurgery, Analytical study.
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