Experience of neurosurgical treatment of chronic subdural hematomas in the Botkin city clinical hospital in 1995-2000

Borzunov A.N., Staroselsky B.S., Sorokin K.V., Kuznetsov K.S., Akopdzhanov G.L., Borzunov A.A.

(Neurosurgical Department of the Botkin City Clinical Hospital, Moscow, Russia)

Results of surgical treatment of 140 patients with chronic subdural hematomas (CSH) in the Botkin City Clinical Hospital in 1995-2000 are given. It should be mentioned, that 95 cases (67.9%) were admitted directly to the Neurosurgical Department; 35 (77.8%) out of 45 patients (32.1%) were delivered to three neurologic departments. The rest 10 cases (22.2%) were admitted to other departments of the hospital. Channels of admission to the Neurosurgical Department, diagnosis on admission to other departments, terms of CT diagnosis are discussed. The analysis of 140 cases with taking into account such criteria, as phases of a clinical picture, associated pathology, operation terms, types of surgical interventions, their results, complications, mortality, etc. is carried out.

History taking showed, that hematoma was caused by trauma in 100 (71%) out of 140 patients. History of other 40 cases (29%) remained unknown. As for age, 85 patients (60.7%) were more than 60 years old. There were 71 males (83.5%); 23 patients (16.4%) were operated in a phase of severe clinical decompensation and a terminal state. Emergency, precipitated and planned operations were performed in 58 (41.4%), 34 (24.3%) and 48 (34.3%) patients respectively. CSH was more than 150 ml in 40 patients (28.6%). Complex endotracheal narcosis, M/A+I/V anesthesia and M/A only were used in 45%, 33% and 22% of patients respectively. The total mortality rate was 13.6%. The report is presented in the form of tables, diagrams, slides with CT images of cases with CSH before and after operation.