Outcomes of Conservative Management of Acute Subdural Hematoma at GCS 15/15 in Post-Traumatic Patients
Keywords:Acute subdural hematoma
Objectives: We observed the results of conservative care of acute subdural hematoma at GCS 15/15 in patients with a head injury from a car accident (RTA).
Material and Methods: It is a comparative observational study of 15 patients with presented to NS -2 Punjab Institute of Neurosciences (PINS), Lahore. Presenting complaints of patients were loss of consciousness, vomiting, headache, ENT bleeding, etc.
Results: The age range was 10 – 70 years. The mean age was 40 years. Conservative management was given to all patients for 10 days except 2 patients. All patients were advised to take complete bed rest for 3 weeks. We advised head ends elevation of all patients up to 15 – 30 degrees to lessen intracranial pressure. Anti-epileptic, mannitol, antibiotics, and acetazolamide were the medication that was given. Our 4 (26%) were hypertensive. Their blood pressures were monitored regularly and kept in the range of 140 – 160 mmHg so that the hematoma may not expand. Our 2 (13%) patients had DM and their BSR levels were monitored and consultation was also done from the diabetes clinic. Our 2 (13%) patients had a headache, and vomiting and which did not resolve so we had to operate on the patients. Midline shift in CT brain was ? 5 mm.
Conclusion: Acute subdural hematoma at GCS 15/15, midline shift was less than 5 mm, and thickness on plain CT brain was greater than 1 cm is best treated by medical management except in 13% of cases.
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