BackgroundAcute traumatic subdural hematoma is life-threatening and is associated with high unfavorable outcomes in developing countries. ObjectiveWe aim to identify factors contributing to outcomes after severe traumatic brain injury (TBI) due to acute subdural hematoma (SDH) in patients admitted to National Hospital Abuja, Nigeria. MethodsThis was a retrospective review of 34 patients who consecutively underwent neurosurgery for acute SDH over five years (from January 2015 to December 2019). Demographic data, clinical characteristics, and the time intervals from injury to surgery were investigated to determine the interactions between all these factors and outcome. Outcome was graded according to the Glasgow outcome scale at the threemonth follow-up. ResultsOut of 34 patients who had surgical evacuation for traumatic acute subdural hematoma, 15 patients died (44.1%). A significant correlation was identified between outcome and the Glasgow coma scale score at admission. No significant correlation was seen between the outcome and the age, gender and the time from injury to surgery (chi 2 test, p>0.05). ConclusionThe rate of unfavorable outcomes in acute subdural hematoma is high. The Glasgow coma score at admission is an important predictor for outcome in traumatic acute subdural hematoma.
Objective: The objective is to determine the prognostic factors affecting the surgical outcome of patients surgically treated for acute epidural haematoma. Materials and Methods: A retrospective review of 71 consecutive patients who underwent neurosurgery for acute epidural haematomas over a 5-year period (from January 2015 to December 2019) was conducted. Clinical characteristics and the time intervals were investigated to determine the interactions between all these factors and the outcome. The outcome was graded according to the Glasgow Outcome Scale (GOS) at subsequent follow-up clinic visits. Results: The severity of traumatic brain injury using the Glasgow Coma Scale score (chi-square test, P = 0.033) had a statistically significant relationship with the outcome. The patients’ age, gender, and total length of time until surgical intervention ( P > 0.05) were of no statistical significance in relation to the outcome. The mortality rate of patients presenting at our centre is 16.9%. Overall, after surgery, 47 of 71 with epidural haematoma had good recovery (GOS 5). Twelve of 71 patients had GOS of 2–4. Twelve patients died. The median duration from injury to presentation was 15 hours with an interquartile range of 15 hours. Conclusion: Our results indicate that the severity of brain injury is an independent risk factor in determining the outcome of epidural haematoma in traumatic brain injury.
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