Sandra Sungailaite
The James Cook University Hospital, UK
Title: The outcome of the patients with chronic subdural hematoma referred to a major trauma centre and review of non-operative management
Biography
Biography: Sandra Sungailaite
Abstract
Objective: The main objective of this study is to review the outcome of chronic subdural hematomas (CSDH) and patients’ characteristics in a cohort referred to a major tertiary trauma centre.
Design: Retrospective audit.
Subjects: Patients with CSDH referred to the trauma centre of North East in the UK between April 2019 and January 2020.
Methods: A retrospective analysis of 88 patients presented over a nine-month period of 2019 to a tertiary centre in the UK with CSDH. We reviewed the referral database collecting data on patients’ age, GCS, presenting symptoms, anticoagulation status and the management outcome. We analyse the radiological findings and clinical outcome of the patients in the different treatment groups.
Results: The results indicated that 88 patients with CSDH were identified during the study period. Twenty (20%) underwent surgery immediately. Forty-eight (55%) were managed conservatively, and 20 (20%) were managed medically with dexamethasone. Subsequently, one of the patients managed conservatively, and one with dexamethasone underwent surgery. Forty-four (54%) out of 88 patients were on various forms of anticoagulation.
Conclusions: This study confirms that operative management was deemed suitable for a small portion of patients referred with CSDH. Medical management with dexamethasone is an option for the patients for whom surgery is not warranted or when a patient is unfit for surgery with good outcome.