Abstract
We have retrospectively reviewed 23 conscious patients, in whom a CT scan diagnosis of acute subdural haematoma was made, and in whom craniotomy for evacuation was not initially performed. These highly selected patients represent 3% of 837 patients with acute subdural haematoma, presenting over a five year, eight month period to the Institute of Neurological Sciences, in Glasgow (1986-1991). Patients with any other associated intracranial abnormalities, such as cerebral contusions, as shown on CT, were excluded from this report. All patients were followed by serial CT scanning, and neurological assessments. Cerebral atrophy was present in over half of the sample. In 17 of our patients, the acute subdural haematoma resolved spontaneously, without evidence of damage to the underlying brain, as shown by CT or neurological findings. Six subsequently required burr hole drainage of a hypodense liquid subdural haematoma. In each of these patients, haematoma thickness was greater than 10 mm. Haematoma volume was significantly larger (53±6 ml versus 32±2 ml) in the group who came to operation. The mean delay between injury and operation in this group was 15 days. We conclude that certain conscious patients with small acute subdural haematomas, without mass effect on CT, may be safely managed conservatively.
| Original language | English |
|---|---|
| Pages (from-to) | 100-108 |
| Number of pages | 9 |
| Journal | Acta Neurochirurgica |
| Volume | 121 |
| Issue number | 3-4 |
| DOIs | |
| State | Published - Sep 1 1993 |
| Externally published | Yes |
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Keywords
- Acute subdural haematoma
- brain atrophy
- conscious patients
- conservative management
ASJC Scopus subject areas
- Surgery
- Clinical Neurology
Cite this
Acute subdural haematoma in the conscious patient : Outcome with initial non-operative management. / Mathew, P.; Oluoch-Olunya, D. L.; Condon, B. R.; Bullock, Ross.
In: Acta Neurochirurgica, Vol. 121, No. 3-4, 01.09.1993, p. 100-108.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acute subdural haematoma in the conscious patient
T2 - Outcome with initial non-operative management
AU - Mathew, P.
AU - Oluoch-Olunya, D. L.
AU - Condon, B. R.
AU - Bullock, Ross
PY - 1993/9/1
Y1 - 1993/9/1
N2 - We have retrospectively reviewed 23 conscious patients, in whom a CT scan diagnosis of acute subdural haematoma was made, and in whom craniotomy for evacuation was not initially performed. These highly selected patients represent 3% of 837 patients with acute subdural haematoma, presenting over a five year, eight month period to the Institute of Neurological Sciences, in Glasgow (1986-1991). Patients with any other associated intracranial abnormalities, such as cerebral contusions, as shown on CT, were excluded from this report. All patients were followed by serial CT scanning, and neurological assessments. Cerebral atrophy was present in over half of the sample. In 17 of our patients, the acute subdural haematoma resolved spontaneously, without evidence of damage to the underlying brain, as shown by CT or neurological findings. Six subsequently required burr hole drainage of a hypodense liquid subdural haematoma. In each of these patients, haematoma thickness was greater than 10 mm. Haematoma volume was significantly larger (53±6 ml versus 32±2 ml) in the group who came to operation. The mean delay between injury and operation in this group was 15 days. We conclude that certain conscious patients with small acute subdural haematomas, without mass effect on CT, may be safely managed conservatively.
AB - We have retrospectively reviewed 23 conscious patients, in whom a CT scan diagnosis of acute subdural haematoma was made, and in whom craniotomy for evacuation was not initially performed. These highly selected patients represent 3% of 837 patients with acute subdural haematoma, presenting over a five year, eight month period to the Institute of Neurological Sciences, in Glasgow (1986-1991). Patients with any other associated intracranial abnormalities, such as cerebral contusions, as shown on CT, were excluded from this report. All patients were followed by serial CT scanning, and neurological assessments. Cerebral atrophy was present in over half of the sample. In 17 of our patients, the acute subdural haematoma resolved spontaneously, without evidence of damage to the underlying brain, as shown by CT or neurological findings. Six subsequently required burr hole drainage of a hypodense liquid subdural haematoma. In each of these patients, haematoma thickness was greater than 10 mm. Haematoma volume was significantly larger (53±6 ml versus 32±2 ml) in the group who came to operation. The mean delay between injury and operation in this group was 15 days. We conclude that certain conscious patients with small acute subdural haematomas, without mass effect on CT, may be safely managed conservatively.
KW - Acute subdural haematoma
KW - brain atrophy
KW - conscious patients
KW - conservative management
UR - http://www.scopus.com/inward/record.url?scp=0027314568&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027314568&partnerID=8YFLogxK
U2 - 10.1007/BF01809258
DO - 10.1007/BF01809258
M3 - Article
C2 - 8512003
AN - SCOPUS:0027314568
VL - 121
SP - 100
EP - 108
JO - Scientific Computing and Instrumentation
JF - Scientific Computing and Instrumentation
SN - 1078-8956
IS - 3-4
ER -