Dhruba Jyoti Kurmi1, Anurag Yadav2, Rocket Chandra Brahma3
BACKGROUND
Chronic subdural hematoma (CSDH) is one of the commonest disease that
affects elderly people. Presentation mimics many other diseases of elderly.
Timely diagnosis and prompt surgical intervention is the key to favourable
outcome. This study was done to obtain baseline data on its various modes of
presentation and management in a tertiary care hospital in north east India.
METHODS
This prospective observational study was conducted at Assam Medical College
and Hospital, Dibrugarh, Assam from June 2016 to end of May 2017. All
radiologically confirmed patients with CSDH were included fulfilling the inclusion
and exclusion criteria. All patients underwent surgical intervention as per
indication. All patients were evaluated in regard of presenting clinical features,
radiological findings, treatment received, peri-operative complications, outcome
and other clinical variables during hospital stay and follow up.
RESULTS
A total of 52 patients were included in the study. Male and female ratio was 3: 1
and 73.08 % patients were aged more than 50 years. Headache was the most
common symptom followed by altered sensorium, limb weakness, intermittent
vomiting, convulsions and others. History of recent trauma was found in 67.31 %
and chronic alcoholism in 28.85 % of patients. Most of the patient (63.46 %)
had Glasgow coma scale (GCS) score 13 - 15. Pure CSDHs were found in 19.23
% and mixed density CSDHs in 80.77 % of patients. Burr hole was done in 48
patients (92.30 %) and craniotomy in 7 (13.46 %). Electrolyte imbalance was
observed in 17.31 % of patients followed by seizures, pulmonary complications
and others. Four patient had moderate disability at the time of discharge and at
the end of one month all discharged patient had good recovery.
CONCLUSIONS
Chronic subdural hematoma is one the common benign disease of old age which
requires high level of suspicion for diagnosis and early radiological investigation.
Timely surgical intervention carries minimal risk of complications with good
recovery for most of the patients. Burr hole is the preferred surgical procedure
for CSDHs with craniotomy reserved for some selected cases.
