Predictors of Outcome in Surgically-Treated Traumatic Acute Subdural Hemorrhage

BACKGROUND: Acute subdural hemorrhage(ASDH) is one of the most morbid entities in traumatic brain injuries(TBI). Many factors can affect the prognosis in ASDH including age, sex, injury severity score (ISS), intracranial pressure (ICP), associated subarachnoid hemorrhage (SAH), Glasgow coma scale (GCS), hypotension, hypoxia and time interval from injury to operation.OBJECTIVE: Evaluate how to achieve better outcomes by addressing factors that impact the outcome.METHODS: The study included 30 patients of various age groups diagnosed with traumatic acute subdural hemorrhage and underwent surgical intervention at our hospital fulfilling the inclusion criteria. Analysis of different factors and their relation to the outcome measured with the Glasgow outcome scale.RESULTS: Preoperative Glasgow coma scale more than 8, reactive pupils, preoperative time interval less than 4 hours wereassociated with better outcome while associated injuries and radiological midline shift more than 1 cm were associated with worse outcome.CONCLUSION: Acute subdural hemorrhage is one of the most morbid traumatic brain injuries. The earlier the surgical intervention on a patient with better Glasgow coma scale and less midline shift the better the outcome will be. Polytrauma patients with marked shift and low Glasgow coma scale have poor prognosis.