Prognosis after acute subdural or epidural haemorrhage

Abstract

In a series of 171 patients suffering acute subdural haemorrhage (SDH) (111 patients) or epidural haemorrhage (EDH) (60 patients) after closed head injury accumulated during the years 1978-1985 at the University Hospital of Graz, the mortality rate and the grade of clinical recovery were evaluated. The overall mortality in acute SDH was 57%, in acute EDH 25%, the percentages of good recoveries--full recovery and minimal neurologic deficit--25 and 58%, respectively. Outcome was found to be predominantly influenced by the preoperative state of consciousness, associated brain lesions, and, in comatose patients, the duration of the time interval between onset of coma and surgical decompression. When this interval exceeded two hours, mortality from SDH rose from 47 to 80% (good outcomes 32 and 4%, respectively). In acute EDH an interval under two hours lead to 17% mortality and 67% of good recoveries compared to 65% mortality and 13% of good recoveries after an interval of more than two hours. Age and concomitant injuries of other body regions proved to be of secondary importance.