The Role of Surgical Treatment in Traumatic Subdural Hygroma: A Pilot Study

Abstract

Background and Aim: Traumatic subdural hygroma is the accumulation of CSF (cerebrospinal fluid) in subdural space following head trauma. The mass effect of hygroma on brain can impinge on consciousness. There are still many ambiguities on indications of hygroma surgery. This is an 11-year follow-up study which involves the patients suffering traumatic subdural hygroma who underwent surgery. Methods & Materials/Patients: In this retrospective study, clinical records of 16 patients who were operated due to traumatic subdural hygroma were studied. The data from existing records in the hospital were collected and analyzed. They were then analyzed by Repeated Measures ANOVA using SPSS (Version 18). The differences were considered statistically significant at P≤0.05. Results: In this study, there were 13 men (81.3%) and 3 women (18.7%) (Mean age=62 years old). In 87.75% of patients, hygroma was diagnosed 6 days after head injury. It wasunilateral in majority of patients (56.3%) and located in fronto-parietal area (81.3%). The most frequent concomitant injuries were contusions (25%) and subarachnoid hemorrhage (18.8%), respectively. GCS trend on admission and at discharge was significantly different fromthat of hygroma formation (P<0.05). One-fourth of patients had recurrence of hygroma after surgery. All patients (except one) had good outcome. Conclusion: Subdural hygroma is a delayed lesion and surgical treatment improves the level of consciousness (LOC) in afflicted patients.

Subdural Hygroma: Different Treatment Modalities and Clinical Outcome

“…They were 2/5 patients (40%) in the conservative group and 2/2 patients (100%) in the surgical group. Many authors reported similar results with a high percentage of good outcome in the younger groups of patients [11] [21]. Severity of brain injury at time of admission is the main factor in determining clinical outcome of the patients regardless of the type of management, as shown in Table 4.…”

“…Whereas patients with mild and moderate GCS showed good recovery (19/22 patients, 86%) regardless of type of management they had (Table 4). Many authors reported similar results with a high percentage of good outcome in patients with mild and moderate Glasgow Coma Score [11] [21] [24]. Other factors as age, gender, site of SDHy or associated pathology had not yet reached a statistical significant value in determining the clinical outcome or even the type of management of patients with subdural hygroma.…”

“…In this study, alteration of the conscious level, neurological deficits and seizures were the main clinical presentation (70%, 36.5% and 13.5% respectively). Yousef-Zadeh et al [11] reported alteration of conscious level and neurological deficit as the main presentation (62.5%) and headache in 50% of their patients. In the present study, 73.3% of our patients were below 40 years; this characterizes a younger and prevalent population.…”

Frequency of Patient Complaints Before and After Legal Medicine Consultation in Orthopedic Ward

“…Reducing the causes of dissatisfaction and correcting them can reduce the burden of clients' dissatisfaction [21][22][23][24]. Also, dissatisfaction can be greatly reduced by informing the clients about the course of the treatment process [25].…”