Outcome of Chronic Subdural Hematoma Evacuation in Association with Its Etiology

Objective: To evaluate outcomes of the chronic subdural hematoma (cSDH) evacuation in association with its etiology at a tertiary care Hospital. Materials & Methods: A prospective clinical cohort study was done at the Neurosurgery department of Pakistan Institute of Medical Sciences (PIMS) Islamabad. Diagnosed cases with cSDH, aged more than 18 years, both genders were scheduled for surgical evacuation by standard neurosurgical techniques as per indications, and Hospital protocols were incorporated. Postoperative CT scans of all patients were examined. Patients were followed for a minimum of 3 months post-surgery. Favorable outcomes were categorized as good recovery and moderate disability, while unfavorable outcomes included severe disability, persistent vegetative state, and death. Results: There were 51 patients with cSDH, with a mean age of 69 years. Males were in majority 74.5% and females were 25.5%. The common causative factor was old age, in 33.3% of cases followed by Trauma 17.6%, old age combined with hypertension (11.8%), hypertension and anticoagulant (7.8%), followed by post-VP shunt (3.9%), and various combinations of old age, trauma, hypertension, anticoagulant use, and alcohol consumption. The good outcome was 92.2% improvement with a moderate disability 3.9%, and 3.9% died. Among patients, those with trauma and hypertension, and hypertension, anticoagulant, and alcohol consumption had worse outcomes, including one death in each group. Conclusion: Overall, outcomes of chronic subdural hematoma evacuation were observed to be favorable. Only two patients died, both of whom had etiological factors such as trauma and hypertension, or hypertension, anticoagulant use, and alcohol consumption.