Traumatic Acute Subdural Hematoma: Prognosis and Operative Timing

Kim,  Kab Teug

J Korean Soc Emerg Med > Volume 11(4); 2000 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2000;11(4): 563-569.

Traumatic Acute Subdural Hematoma: Prognosis and Operative Timing

ABSTRACT

BACKGROUND: Traumatic acute subdural hematoma remains one of the most lethal of all head injuries. It has been strongly held that the critical factor in the overall outcome from acute subdural hematoma is the timing of operative intervention for clot removal; those operated on within 4 hours of injury may have a marked decrease in mortality and morbidity.
METHODS:
Data were reviewed for 79 patients with a traumatic acute subdural hematoma during 2 years between January 1997 and December 1998. Treatment protocol included rapid operative intervention and aggressive postoperative control of intracranial pressure.
RESULTS:
The overall mortality rate was 63.3%, and 21.5% had functional recovery. The following variables statistically correlated(pCONCLUSION:
Earlier surgical removal of the hematoma has a better prognosis, but the operative timing-within the first 4 hours-may not be critical to the outcome.