EXTRA DURAL HEMATOMA SURGICAL OUTCOME USING GLASGOW COMA SCALE IN A TERTIARY CARE HOSPITAL OF KHYBER PAKHTUNKHWA

Abstract

Objectives: To determine the frequency of various surgical outcomes of acute extra dural hematoma (EDH) in the Department of Neurosurgery, Lady Reading Hospital, Peshawar.

Methodology: This was a case series study conducted in Neurosurgery Department, Lady Reading Hospital (LRH) Peshawar, from 1^st January 2009 to 30^th September 2009. Total 145 consecutive patients of acute extradural hematoma were admitted and their baseline GCS was recorded. They were operated by consultant neurosurgeon. Post-operative outcome including good recovery, moderate disability, severe disability, persistent vegetative state and death were recorded.

Results: Out of 145 cases, 82% were male and 18% were female. Majority of the cases were less than14 years old. Fall was the cause of EDH in 60% patients, road traffic accident (RTA) in 26% and physical assault was the mode of injury in 14%. Interval between injury and surgery of more than 8 hours was recorded in majority of the cases. Parietal lobe was the commonest site of EDH.  Craniotomy was performed in 80% cases and craniectomy in 20% cases. Post-operative GCS of 13-15 was noted in 123 (85%) cases compared to  GCS at arrival of 13-15 in 72 (50%) cases. Post-operatively, good recovery was noted in majority of the cases (n=123, 85%)  having higher GCS scores (13-15).

Conclusion: Surgical outcome in EDH patient is affected by GCS. Lower GCS have poor outcome. Good recovery was noted in maximum cases.