J Korean Soc Emerg Med.  2000 Dec;11(4):563-569.

Traumatic Acute Subdural Hematoma: Prognosis and Operative Timing

• Kim KT

Abstract

BACKGROUND: Traumatic acute subdural hematoma remains one of the most lethal of all head injuries. It has been strongly held that the critical factor in the overall outcome from acute subdural hematoma is the timing of operative intervention for clot removal; those operated on within 4 hours of injury may have a marked decrease in mortality and morbidity.
METHODS
Data were reviewed for 79 patients with a traumatic acute subdural hematoma during 2 years between January 1997 and December 1998. Treatment protocol included rapid operative intervention and aggressive postoperative control of intracranial pressure.
RESULTS
The overall mortality rate was 63.3%, and 21.5% had functional recovery. The following variables statistically correlated(pCONCLUSION
Earlier surgical removal of the hematoma has a better prognosis, but the operative timing-within the first 4 hours-may not be critical to the outcome.

MeSH Terms

Clinical Protocols
Craniocerebral Trauma
Hematoma
Hematoma, Subdural, Acute*
Humans
Intracranial Pressure
Linear Models
Mortality
Prognosis*
Pupil