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Chronic subdural hematoma: Wide dural window and incision of inner membrane

Authors: Nnadi Mathias O. N., Bankole Olufemi B. and Olatosi John O.

Int J Med Res Health Sci.85-92 | pdf PDF Full Text

ABSTRACT
Surgical treatment of chronic subdural hematoma can give dramatic recovery and the patient and his relatives see
the surgeon as a ‘miracle’ worker. This euphoria can suddenly give way to anguish whenever recurrence occurs.
Many methods of surgical care have arisen in the bid to avoid the despair of recurrence. The objectives of the study
were to evaluate the Glasgow outcome scores and recurrence in wide dural window and incision of inner membrane
in chronic subdural hematoma surgeries. It was a prospective study on patients with chronic subdural hematoma
managed in our centers from 2009 to 2015. Patients were resuscitated with Advance Trauma Life Support protocols
in accident and emergency. Brain Computerized tomography scan was used to make diagnosis. The hematoma was
evacuated using large burr hole for liquefied types and craniotomy for those with solid components. The dural/outer
membrane incision was widened and the inner membrane incised. On discharge, patients were followed up for three
months. Data were collected using proforma and analyzed using Environmental Performance Index info 7 software.
There were 55 patients. Males were forty six. The mean age was 56.6 years. The most common etiology was road
traffic accident. The favorable outcome was 94.54%. The Glasgow Coma Scores (GCS) prior to surgery affected the
outcome. There was no recurrence. The use of wide dural opening and incision of the inner membrane was not
associated with any recurrence and complications were few. It is recommended as a suitable treatment option for
patients with chronic subdural hematoma.
Keywords: chronic subdural hematoma, dura, membrane, window

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