Correlation between computerised tomography (CT) findings, clinical presentation and immediate postoperative results in subdural haematoma

Abstract

This prospective study was conducted between January 2003 to January 2004 in National Center of Neurological Sciences (Al Shaab Teaching Hospital), to deal with postoperative immediate outcome of patients with subdural hematoma in correlation with CT scan findings and clinical presentation. One hundred randomly selected patients with 116 subdural hematomas were operated on depending upon CT scan findings. The age range for the study group was 37-90 years with a mean of 65 years. Of the total (100 patients), male to female ratio was 9:1 (90:10). Thirty-six patients (36%) did not have any history of trauma, 44 (44%) patients with history of a minor trauma and 20 (20%) patients were sustained with a relatively severe trauma. Eighty-five (85%) patients had CT scan finding of brain atrophy. Seventy-eight patients (78%) had unilateral SDHs and 22 (22%) patients with bilateral SDHs. 7 Eighteen SDHs (15.5%) were purely hyperdense, 64 SDHs (55.2%) with mixed density and 29.3% (n= 39) were purely hypodense. The mass effect of SDHs was seen clearly as midline shift or compression on the ventricles. This study showed no correlation between the immediate outcome and CT scan findings like density, number, mass effect or the midline shift. Also there is no correlation with the time delay between start of complaint, CT diagnosis and interventional management. The correlation is present with the clinical presentation at the time of admission especially for the dead cases (6%). These results may be changed to a certain degree if the sample size is larger or if any type of SDHs studied separately.