The Results of the Use of Multiple Fenestrations of the Dura in Acute Traumatic Subdural Hematoma in Elderly

, Yeonjin Lee; , Kwangjin Lee; , Jongtae Park

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2015;11(2):163-166.
Published online September 30, 2015.

The Results of the Use of Multiple Fenestrations of the Dura in Acute Traumatic Subdural Hematoma in Elderly

Yeonjin Lee , Kwangjin Lee , Jongtae Park

Department of Neurosurgery, Wonkwang University College of Medicine, Jeonbuk, Korea

노인 급성 외상성 경막하 출혈 환자에서 다발성 경막천공술을 이용한 두부 감압수술의 결과

이연진·이광진·박종태

원광대학교 의과대학 신경외과학교실

Abstract

Objective
To evaluate the operative outcome and prognostic factors in patients over the age of 65 years who undergone a craniectomy with the use of multiple fenestrations of the dura in acute traumatic subdural hematoma.
Methods
Between January 2012 and December 2014, thirty four patients (22 males, 12 females) over the age of 65 years who had undergone surgical intervention of acute traumatic subdural hematoma were retrospectively analyzed. Major preoperative clinical parameters such as mechanism of injury, Glasgow coma scale (GCS) score at admission and computed tomography (CT) findings were analyzed for prognostic significance.
Results
Twelve (35.3%) patients had good outcome and twenty two (64.7%) had poor outcome. GCS score and the presence of significant midline shift on CT had reached statistical significance in predicting outcome.
Conclusion
Surgical outcome is unexceptionally poor in the elderly patients with acute traumatic subdural hematoma even the use of multiple fenestrations of the dura, especially in those patients who had GCS 8 or below and the presence of significant midline shift on CT.

Key Words: Acute subdural hematomaㆍElderlyㆍDural fenestrationㆍDecompression