Effectiveness of managing patients with subdural hematoma with a volume of 60-100 cm3 of various localization

The aim of the study was to determine the relationship between the effectiveness of treatment of patients with traumatic brain injury complicated by subdural hematoma and the localization of the hematoma. 

Materials and methods. The medical documentation of 52 patients with traumatic brain injury (TBI) complicated by acute subdural hematoma with a volume of 60-100 cm3 was retrospectively analyzed. Patients were divided into 3 groups depending on the location of the hematoma: group I consisted of 21 patients (40%) with hematoma localization in the frontotemporal region, group II - 18 patients (35%) with hematoma localization in the parietal - temporal region, group III - 13 patients (25%) with hematoma localization in the frontotemporal - occipital region. When patients are discharged from the hospital, their condition indicators are calculated according to the Rankin scale. 

Results. More often subdural hematomas were localized in the frontotemporal and parietal-temporal regions, less often in the frontotemporal-occipital region. The severity of the victims' condition, estimated at less than 10 points according to the Glasgow scale, prevailed in patients with TBI complicated by subdural hematoma localized in the frontal-parietal-occipital region. The volume of hematoma localized in the frontal-parietal-occipital region prevailed in comparison with the frontal-temporal and parietal-temporal regions (p<0.01). After completing treatment in a specialized department, the degree of independence and disability, less than 2 points according to the Rankin scale, was established in 31 (60%) of the 52 victims; of these, in 18 (35%) patients, the hematoma was localized in the frontotemporal region. 

Conclusion. The results of surgical treatment of patients with TBI complicated by subdural hematoma with a volume of 60-100 cm3 are interrelated with its localization. The best indicators of treatment effectiveness were found in patients with subdural hematoma localized in the frontotemporal region. The least effective treatment was observed when the hematoma was localized in the frontal-parietal-occipital region.

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