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Outcome Difference Between Traumatic and Spontaneous Chronic Subdural Hematoma

Author(s)
Sanaullah Pathan Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS),Jamshoro, Pakistan
Abdul Rauf Memon Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS),Jamshoro,Pakistan
Peer Asad Aziz Department of Neurosurgery, Bilawal Medical Collage,Jamshoro,Pakistan
Muzafar Ali Bhand Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS),Jamshoro,Pakistan
Suhail Ahmed Aghani Department of Neurosurgery, Muhammad Medical Collage,Mirpurkhas,Pakistan
Hameedullah Khan Department of Neurosurgery, Indus Medical College,Tando Muhammad Khan , Pakistan
Zeeshan Nasir Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS),Jamshoro,Pakistan
Abstract
Introduction & Objective: Chronic subdural is one of the most common neurosurgical disorders and affects older populations, its incidence increases with increasing age, i.e., 36.6 to 91%. The main objective is to evaluate the outcome difference between traumatic and spontaneous CSDH. Materials and Methods: A case-control study was conducted in Liaquat University Hospital. The duration of the study was from 1st Jan 2023 to 1st September 2023. The patients included in the study were divided into two groups either spontaneous or old history of trauma less than 3 months. The Pre-operative and postoperative GCS were noted. The post-operative (on discharge) GCOSE was noted. Results: Total number of 32 patients with 16 in a single group were included, the mean age was 60, out of which 65.6% were males with the most common presentation being AlOC (75%). The mean Pre-operative GCS in the spontaneous and traumatic groups was (8.37 ± 3.87 vs 12.56 ± 2.78) respectively and the traumatic group presented with good GCS (OR 1.417, p- 0.002). After surgery, the mean GCS in the spontaneous and traumatic group was (9.62 ± 5.01 vs 12.81 ± 3.22) (p-0.058). The post-operative GCOSE in the spontaneous group was mostly Grade I (Dead, 56.2%) and Grade VIII (upper good recovery, 62.5%) in the traumatic group. The effect of GCOSE either on each group is significant (p- 0.05) with spontaneous CSDH having 3.07 more chances of being dead. Conclusion: The spontaneous group holds grave outcomes as compared to the traumatic group. Both Groups do improve immediate Post-operative GCS but the GCOES grading worsens with spontaneous group.
Publication Details
Page(s) 184-191
DOI 10.36552/pjns.v28i2.961
Published Journal: Pakistan Journal of Neurological Surgery, Volume: 28, Issue: 2, Year: 2024

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Keywords
traumatic, Head trauma, Spontaneous, no-head trauma, GCOSE, CSDH
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