Abstract:
Objective: To determine the functional outcome in patients undergoing wide decompressive craniectomy to remove ASDH with “Dural Stabs” versus “ Open Dural flap”. Subject and Methods: This comparative study was conducted at department of Neurosurgery, Dow University of Health Sciences, Civil Hospital Karachi with one year duration from 2013 to 2014. All the patients with acute subdural haematoma and associated intracranial brain injury such as contusion, brain edema and/or subarachnoid hemorrhage were included in the study. Patients were randomly allocated into two groups. Thirty-seven patients were treated with Dural Stabs and 37 were treated with Open Dural Flap. Under general anesthesia, after all aseptic measures, a skin incision at the side of hematoma was given. Free bone flap craniectomy via 4 or 5 burr hole, followed by evacuation of hematoma with either “Dural Stabs” or “Open Dural Flap” was done. Postoperatively all patients was shifted to surgical ICU. Functional outcome i.e. either “Good Outcome” or “Poor Outcome” was measured at the time of discharge by G.O.S. All the data was recorded on the proforma. Results: Total 74 cases were studied; thirty-seven patients were treated with Dural Stabs and 37 were treated with Open Dural Flap. The mean age of the patients was 34.73±9.54 years. Out of 74 cases, there were 45(60.8%) male and 29(39.2%) female. The good functional outcome was significantly high in dural stabs as compare to open dural flap (86.5% vs. 32.4%; p=0.0005). Furthermore, age group of 21 to 40 years had a good outcome as compared to the age group of 41 to 60 years but it was non-significant. Conclusion: It is concluded that stabing the dura at intervals decompressed the underlying edematous brain slowly with better results, in comparison to the open dural flap.
Page(s):
267-271
DOI:
DOI not available
Published:
Journal: Annals of the Pakistan Institute of Medical Sciences, Volume: 13, Issue: 3, Year: 2017