Results of treatment of patients with an acute small traumatic subdural hematoma

Abstract

Patients with small acute traumatic subdural hematomas in the compensated clinical condition can be managed conservatively and have a favorable outcome. We have analyzed our own experience of conservative management of 94 patients with small acute traumatic subdural hematomas. In 16 patients (17 %), hematoma expansion occurred in the next 2–7 days and surgical treatment was required. Significant factors of hematoma expansion are its initial maximum thickness of 8–9 mm and arterial hypertension during the observation period in the hospital. There were no lethal cases in the group of patients who required delayed surgical treatment. Clinical outcomes, both in the conservative group and in the group requiring delayed surgery, did not differ significantly; all patients were discharged with 4–5 points on the Glasgow Outcome Scale. Thus, conservative management of patients with small acute subdural hematomas is safe even in case of hematoma expansion with timely surgical intervention