Outcome Difference between Traumatic and Spontaneous Chronic subdural hematoma


  • Sanaullah Pathan Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro
  • Abdul Rauf Memon Department of Neurosurgery, Bilawal Medical Collage, Jamshoro
  • Peer Asad Aziz Department of Neurosurgery, Bilawal Medical Collage, Jamshoro
  • Muzafar Ali Bhand Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro
  • Suhail Ahmed Aghani Department of Neurosurgery, Muhammad Medical Collage, Mirpurkhas
  • Hameedullah Khan Department of Neurosurgery, Indus Medical College, Tando Muhammad Khan – Pakistan
  • Zeeshan Nasir Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro




chronic sub dural, spontaneous, traumatic, etiology


Objective: To evaluate the effect of traumatic or spontaneous etiology on outcome of CSDH patients

Material and methods: It is retrospect case control study and was conducted in Liaquat University hospital. The duration of study was 1st Jan 2023 to 1stJan 2024. The patient that was included in study was divide into two groups either spontaneous or old history of trauma less than 3 months. The Pre-operative and post-operative GCS were noted. The post-operative (on discharge) GOSE were noted.

Results: Total numbers of 32 patients with 16 in single group were included, the mean age was 60, out of which 65.6% were males. . After surgery, the mean GCS in spontaneous group was 9.62 and 12.81 in traumatic group (p-0.020). The post-operative GOSE in spontaneous group was mostly Grade I (Dead, 56.2%) and Grade VIII (upper good recovery, 62.5%) in traumatic group. The effect on GOES either spontaneous or traumatic is non-significant that p- 0.051, but the spontaneous CSDH has more chances of being dead as compare to traumatic CSDH and vice versa with Odd ratio of 1.2.

Conclusion: The spontaneous etiology holds grave outcomes as compare to traumatic etiology. Both etiologies do improve the immediate Post-operative GCS but the GOES grading worsens with spontaneous etiology. 


Rauhala M, Helén P, Huhtala H, Heikkilä P, Iverson GL, Niskakangas T, et al. Chronic subdural hematoma—incidence, complications, and financial impact. Acta Neurochirurgica. 2020;162(9):2033-43.

Takei J, Hirotsu T, Hatano K, Ishibashi T, Inomata T, Noda Y, et al. Modified computed tomography classification for chronic subdural hematoma features good interrater agreement: a single-center retrospective cohort study. World Neurosurgery. 2021;151:e407-e17.

Wang HS, Kim SW, Kim SH. Spontaneous chronic subdural hematoma in an adolescent girl. Journal of Korean Neurosurgical Society. 2013;53(3):201-3.

Toop N, McGahan B, Shah V, McGregor J. Chronic Subdural Hematoma. Neurotrauma. 2019:27.

Kostic A, Kehayov I, Stojanovic N, Nikolov V, Kitov B, Miloševic P, et al. Spontaneous chronic subdural hematoma in elderly people–Arterial hypertension and other risk factors. Journal of the Chinese Medical Association. 2018;81(9):781-6.

Nouri A, Gondar R, Schaller K, Meling T. Chronic Subdural Hematoma (cSDH): A review of the current state of the art. Brain and Spine. 2021;1:100300.

Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurologia medico-chirurgica. 2001;41(8):371-81.






Original Articles