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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(03): 454-467
DOI: 10.1055/s-0043-1772763
Review Article

Prognostic Factors of Mortality and Functional Outcome for Acute Subdural Hematoma: A Review Article

Nathan Beucler 
1   Neurosurgery Department, Sainte-Anne Military Teaching Hospital, Toulon, France
2   Ecole du Val-de-Grâce, French Military Health Service Academy, Paris, France
› Institutsangaben Funding None.
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Abstract

Acute subdural hematoma (ASDH) is the most frequent intracranial traumatic lesion requiring surgery in high-income countries. To date, uncertainty remains regarding the odds of mortality or functional outcome of patients with ASDH, regardless of whether they are operated on. This review aims to shed light on the clinical and radiologic factors associated with ASDH outcome. A scoping review was conducted on Medline database from inception to 2023. This review yielded 41 patient series. In the general population, specific clinical (admission Glasgow Coma Scale [GCS], abnormal pupil exam, time to surgery, decompressive craniectomy, raised postoperative intracranial pressure) and radiologic (ASDH thickness, midline shift, thickness/midline shift ratio, uncal herniation, and brain density difference) factors were associated with mortality (grade III). Other clinical (admission GCS, decompressive craniectomy) and radiologic (ASDH volume, thickness/midline shift ratio, uncal herniation, loss of basal cisterns, petechiae, and brain density difference) factors were associated with functional outcome (grade III). In the elderly, only postoperative GCS and midline shift on brain computed tomography were associated with mortality (grade III). Comorbidities, abnormal pupil examination, postoperative GCS, intensive care unit hospitalization, and midline shift were associated with functional outcome (grade III). Based on these factors, the SHE (Subdural Hematoma in the Elderly) and the RASH (Richmond Acute Subdural Hematoma) scores could be used in daily clinical practice. This review has underlined a few supplementary factors of prognostic interest in patients with ASDH, and highlighted two predictive scores that could be used in clinical practice to guide and assist clinicians in surgical indication.

Keywords

acute subdural hematoma - functional prognostic - mortality - review - traumatic brain injury


Publikationsverlauf

Artikel online veröffentlicht:
31. August 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Clark D, Joannides A, Adeleye AO. et al; Global Neurotrauma Outcomes Study collaborative. Casemix, management, and mortality of patients rreseceiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study. Lancet Neurol 2022; 21 (05) 438-449
    CrossrefPubMedSuche in Google Scholar
  • 2 Baucher G, Troude L, Pauly V, Bernard F, Zieleskiewicz L, Roche P-H. Predictive factors of poor prognosis after surgical management of traumatic acute subdural hematomas: a single-center series. World Neurosurg 2019; 126: e944-e952
    CrossrefPubMedSuche in Google Scholar
  • 3 Goldman D. The economic promise of delayed aging. Cold Spring Harb Perspect Med 2015; 6 (02) a025072
    CrossrefPubMedSuche in Google Scholar
  • 4 Kelly ML, Shammassian B, Roach MJ, Thomas C, Wagner AK. Craniectomy and craniotomy in traumatic brain injury: a propensity-matched analysis of long-term functional and quality of life outcomes. World Neurosurg 2018; 118: e974-e981
    CrossrefPubMedSuche in Google Scholar
  • 5 Dagain A, Aoun O, Sellier A. et al. Acute neurosurgical management of traumatic brain injury and spinal cord injury in French armed forces during deployment. Neurosurg Focus 2018; 45 (06) E9
    CrossrefPubMedSuche in Google Scholar
  • 6 Beucler N, Dagain A. Letter to the Editor. Decompressive craniectomy: the simpler, the better. J Neurosurg 2022; 136 (06) 1814-1815
    CrossrefPubMedSuche in Google Scholar
  • 7 Won S-Y, Dubinski D, Brawanski N. et al. Significant increase in acute subdural hematoma in octo- and nonagenarians: surgical treatment, functional outcome, and predictors in this patient cohort. Neurosurg Focus 2017; 43 (05) E10
    CrossrefPubMedSuche in Google Scholar
  • 8 Beucler N, Cungi P-J, Baucher G, Coze S, Dagain A, Roche P-H. The Kernohan-Woltman Notch Phenomenon : a systematic review of clinical and radiologic presentation, surgical management, and functional prognosis. J Korean Neurosurg Soc 2022; 65 (05) 652-664
    CrossrefPubMedSuche in Google Scholar
  • 9 Beucler N, Dagain A. Decompressive craniectomy: keep it simple!. Acta Neurochir (Wien) 2022; . PMID: 35717427
    CrossrefPubMedSuche in Google Scholar
  • 10 Evans LR, Jones J, Lee HQ. et al. Prognosis of acute subdural hematoma in the elderly: a systematic review. J Neurotrauma 2019; 36 (04) 517-522
    CrossrefPubMedSuche in Google Scholar
  • 11 Manivannan S, Spencer R, Marei O. et al. Acute subdural haematoma in the elderly: to operate or not to operate? A systematic review and meta-analysis of outcomes following surgery. BMJ Open 2021; 11 (12) e050786
    CrossrefPubMedSuche in Google Scholar
  • 12 Widdop L, Kaukas L, Wells A. Effect of pre-management antithrombotic agent use on outcome after traumatic acute subdural hematoma in the elderly: a systematic review. J Neurotrauma 2023; 40 (7–8): 635-648
    CrossrefPubMedSuche in Google Scholar
  • 13 Perel P, Arango M, Clayton T. et al; MRC CRASH Trial Collaborators. Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. BMJ 2008; 336 (7641) 425-429
    CrossrefPubMedSuche in Google Scholar
  • 14 Steyerberg EW, Mushkudiani N, Perel P. et al. Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. PLoS Med 2008; 5 (08) e165 , discussion e165
    CrossrefPubMedSuche in Google Scholar
  • 15 Alford EN, Rotman LE, Erwood MS. et al. Development of the subdural hematoma in the elderly (SHE) score to predict mortality. J Neurosurg 2019; 132 (05) 1616-1622
    CrossrefPubMedSuche in Google Scholar
  • 16 Jin X-Q, Du X-F, Yang M-F, Zhang Q. Development and validation of prognostic model for patients with acute subdural hematoma-reliable nomogram. World Neurosurg 2018; 124: e266-e275
    CrossrefPubMedSuche in Google Scholar
  • 17 Dincer A, Stanton AN, Parham KJ. et al. The Richmond Acute Subdural Hematoma Score: a validated grading scale to predict postoperative mortality. Neurosurgery 2022; 90 (03) 278-286
    CrossrefPubMedSuche in Google Scholar
  • 18 Won S-Y, Dubinski D, Herrmann E. et al. Epileptic seizures in patients following surgical treatment of acute subdural hematoma-incidence, risk factors, patient outcome, and development of new scoring system for prophylactic antiepileptic treatment (GATE-24 score). World Neurosurg 2017; 101: 416-424
    CrossrefPubMedSuche in Google Scholar
  • 19 de Souza MR, Fagundes CF, Solla DJF. et al. Mismatch between midline shift and hematoma thickness as a prognostic factor of mortality in patients sustaining acute subdural hematoma. Trauma Surg Acute Care Open 2021; 6 (01) e000707
    CrossrefPubMedSuche in Google Scholar
  • 20 Cruz J, Minoja G, Okuchi K. Improving clinical outcomes from acute subdural hematomas with the emergency preoperative administration of high doses of mannitol: a randomized trial. Neurosurgery 2001; 49 (04) 864-871
    PubMedSuche in Google Scholar
  • 21 García-Pérez D, Panero-Pérez I, Eiriz Fernández C. et al. Densitometric analysis of brain computed tomography as a new prognostic factor in patients with acute subdural hematoma. J Neurosurg 2020; 134 (06) 1940-1950
    CrossrefPubMedSuche in Google Scholar
  • 22 Li Z, Feng Y, Wang P. et al. Evaluation of the prognosis of acute subdural hematoma according to the density differences between gray and white matter. Front Neurol 2023; 13: 1024018
    CrossrefPubMedSuche in Google Scholar
  • 23 Panczykowski DM, Okonkwo DO. Premorbid oral antithrombotic therapy and risk for reaccumulation, reoperation, and mortality in acute subdural hematomas. J Neurosurg 2011; 114 (01) 47-52
    CrossrefPubMedSuche in Google Scholar
  • 24 Seelig JM, Becker DP, Miller JD, Greenberg RP, Ward JD, Choi SC. Traumatic acute subdural hematoma: major mortality reduction in comatose patients treated within four hours. N Engl J Med 1981; 304 (25) 1511-1518
    CrossrefPubMedSuche in Google Scholar
  • 25 Haselsberger K, Pucher R, Auer LM. Prognosis after acute subdural or epidural haemorrhage. Acta Neurochir (Wien) 1988; 90 (3-4): 111-116
    CrossrefPubMedSuche in Google Scholar
  • 26 Wilberger Jr JE, Harris M, Diamond DL. Acute subdural hematoma: morbidity, mortality, and operative timing. J Neurosurg 1991; 74 (02) 212-218
    CrossrefPubMedSuche in Google Scholar
  • 27 Cagetti B, Cossu M, Pau A, Rivano C, Viale G. The outcome from acute subdural and epidural intracranial haematomas in very elderly patients. Br J Neurosurg 1992; 6 (03) 227-231
    CrossrefPubMedSuche in Google Scholar
  • 28 Yanaka K, Kamezaki T, Yamada T, Takano S, Meguro K, Nose T. Acute subdural hematoma–prediction of outcome with a linear discriminant function. Neurol Med Chir (Tokyo) 1993; 33 (08) 552-558
    CrossrefPubMedSuche in Google Scholar
  • 29 Cook RJ, Fearnside MR, McDougall P, McNeil RJ. The Westmead head injury project: outcome prediction in acute subdural haematoma. J Clin Neurosci 1996; 3 (02) 143-148
    CrossrefPubMedSuche in Google Scholar
  • 30 Massaro F, Lanotte M, Faccani G, Triolo C. One hundred and twenty-seven cases of acute subdural haematoma operated on. Correlation between CT scan findings and outcome. Acta Neurochir (Wien) 1996; 138 (02) 185-191
    CrossrefPubMedSuche in Google Scholar
  • 31 Koç RK, Akdemir H, Oktem IS, Meral M, Menkü A. Acute subdural hematoma: outcome and outcome prediction. Neurosurg Rev 1997; 20 (04) 239-244
    CrossrefPubMedSuche in Google Scholar
  • 32 Servadei F, Nasi MT, Giuliani G. et al. CT prognostic factors in acute subdural haematomas: the value of the ‘worst’ CT scan. Br J Neurosurg 2000; 14 (02) 110-116
    CrossrefPubMedSuche in Google Scholar
  • 33 Zhao H, Bai XJ. Influence of operative timing on prognosis of patients with acute subdural hematoma. Chin J Traumatol 2009; 12 (05) 296-298
    PubMedSuche in Google Scholar
  • 34 Kim K-H. Predictors for functional recovery and mortality of surgically treated traumatic acute subdural hematomas in 256 patients. J Korean Neurosurg Soc 2009; 45 (03) 143-150
    CrossrefPubMedSuche in Google Scholar
  • 35 Chieregato A, Noto A, Tanfani A, Bini G, Martino C, Fainardi E. Hyperemia beneath evacuated acute subdural hematoma is frequent and prolonged in patients with an unfavorable outcome: a xe-computed tomographic study. Neurosurgery 2009; 64 (04) 705-717 , discussion 717–718
    CrossrefPubMedSuche in Google Scholar
  • 36 Wong GK-C, Hung Y-W, Chong C. et al. Assessing the neurological outcome of traumatic acute subdural hematoma patients with and without primary decompressive craniectomies. Acta Neurochir Suppl (Wien) 2010; 106: 235-237
    CrossrefPubMedSuche in Google Scholar
  • 37 Karasu A, Civelek E, Aras Y. et al. Analyses of clinical prognostic factors in operated traumatic acute subdural hematomas. Ulus Travma Acil Cerrahi Derg 2010; 16 (03) 233-236
    PubMedSuche in Google Scholar
  • 38 Tien HCN, Jung V, Pinto R, Mainprize T, Scales DC, Rizoli SB. Reducing time-to-treatment decreases mortality of trauma patients with acute subdural hematoma. Ann Surg 2011; 253 (06) 1178-1183
    CrossrefPubMedSuche in Google Scholar
  • 39 Leitgeb J, Mauritz W, Brazinova A. et al. Outcome after severe brain trauma due to acute subdural hematoma. J Neurosurg 2012; 117 (02) 324-333
    CrossrefPubMedSuche in Google Scholar
  • 40 Li LM, Kolias AG, Guilfoyle MR. et al. Outcome following evacuation of acute subdural haematomas: a comparison of craniotomy with decompressive craniectomy. Acta Neurochir (Wien) 2012; 154 (09) 1555-1561
    CrossrefPubMedSuche in Google Scholar
  • 41 Baraniskin A, Steffens C, Harders A, Schmiegel W, Schroers R, Spangenberg P. Impact of pre-hospital antithrombotic medication on the outcome of chronic and acute subdural hematoma. J Neurol Surg A Cent Eur Neurosurg 2014; 75 (01) 31-36
    Thieme ConnectPubMedSuche in Google Scholar
  • 42 Kalayci M, Aktunç E, Gül S. et al. Decompressive craniectomy for acute subdural haematoma: an overview of current prognostic factors and a discussion about some novel prognostic parametres. J Pak Med Assoc 2013; 63 (01) 38-49
    PubMedSuche in Google Scholar
  • 43 Yamaguchi T, Takai H, Hirai S. et al. Microbleeds as a prognostic factor for acute subdural hematoma. Neurol Med Chir (Tokyo) 2013; 53 (05) 318-322
    CrossrefPubMedSuche in Google Scholar
  • 44 Inamasu J, Hasegawa M, Hayashi T, Kato Y, Hirose Y. Hemispheric differences in the surgical outcomes of patients with traumatic acute subdural hematoma. J Negat Results Biomed 2014; 13 (01) 10
    CrossrefPubMedSuche in Google Scholar
  • 45 Raj R, Mikkonen ED, Kivisaari R, Skrifvars MB, Korja M, Siironen J. Mortality in elderly patients operated for an acute subdural hematoma: a surgical case series. World Neurosurg 2016; 88: 592-597
    CrossrefPubMedSuche in Google Scholar
  • 46 Alagoz F, Yildirim AE, Sahinoglu M. et al. Analysis of traumatic acute subdural hematomas: outcomes and predictive factors in a single center experience. Turkish Neurosurgery 2015
    CrossrefPubMedSuche in Google Scholar
  • 47 Lenzi J, Caporlingua F, Caporlingua A. et al. Relevancy of positive trends in mortality and functional recovery after surgical treatment of acute subdural hematomas. Our 10-year experience. Br J Neurosurg 2017; 31 (01) 78-83
    CrossrefPubMedSuche in Google Scholar
  • 48 Kwon YS, Yang KH, Lee YH. Craniotomy or decompressive craniectomy for acute subdural hematomas: surgical selection and clinical outcome. Korean J Neurotrauma 2016; 12 (01) 22-27
    CrossrefPubMedSuche in Google Scholar
  • 49 Lee D, Song SW, Choe WJ, Cho J, Moon CT, Koh Y-C. Risk stratification in patients with severe traumatic acute subdural hematoma. Nerve 2017; 3: 50-57
    CrossrefSuche in Google Scholar
  • 50 Vilcinis R, Bunevicius A, Tamasauskas A. The association of surgical method with outcomes of acute subdural hematoma patients: experience with 643 consecutive patients. World Neurosurg 2017; 101: 335-342
    CrossrefPubMedSuche in Google Scholar
  • 51 Karnjanasavitree W, Phuenpathom N, Tunthanathip T. The optimal operative timing of traumatic intracranial acute subdural hematoma correlated with outcome. Asian J Neurosurg 2018; 13 (04) 1158-1164
    Thieme ConnectPubMedSuche in Google Scholar
  • 52 Lavrador JP, Teixeira JC, Oliveira E, Simão D, Santos MM, Simas N. Acute subdural hematoma evacuation: predictive factors of outcome. Asian J Neurosurg 2018; 13 (03) 565-571
    Thieme ConnectPubMedSuche in Google Scholar
  • 53 Yılmaz İ, Ertem DH, Kılıç M. et al. Factors associated with mortality in acute subdural hematoma: is decompressive craniectomy effective?. Ulus Travma Acil Cerrahi Derg 2019; 25 (02) 147-153
    PubMedSuche in Google Scholar
  • 54 Akbik OS, Starling RV, Gahramanov S, Zhu Y, Lewis J. Mortality and functional outcome in surgically evacuated acute subdural hematoma in elderly patients. World Neurosurg 2019; 126: e1235-e1241
    CrossrefPubMedSuche in Google Scholar
  • 55 Altaf I, Shams S, Vohra AH. Role of surgical modality and timing of surgery as clinical outcome predictors following acute subdural hematoma evacuation. Pak J Med Sci 2020; 36 (03) 412-415
    CrossrefPubMedSuche in Google Scholar
  • 56 Trevisi G, Sturiale CL, Scerrati A. et al. Acute subdural hematoma in the elderly: outcome analysis in a retrospective multicentric series of 213 patients. Neurosurg Focus 2020; 49 (04) E21
    CrossrefPubMedSuche in Google Scholar
  • 57 Igbokwe KK, Ayogu OM, Onobun DE, Essiet EA, Ugwuanyi UC. The outcomes of traumatic acute subdural hematoma in a tertiary center in Abuja, Nigeria. Cureus 2021; 13 (11) e20016
    PubMedSuche in Google Scholar
  • 58 Younsi A, Fischer J, Habel C. et al. Mortality and functional outcome after surgical evacuation of traumatic acute subdural hematomas in octa- and nonagenarians. Eur J Trauma Emerg Surg 2021; 47 (05) 1499-1510
    CrossrefPubMedSuche in Google Scholar
  • 59 Krueger EM, Benveniste RJ, Taylor RR. et al. Neurologic outcomes for octogenarians undergoing emergent surgery for traumatic acute subdural hematoma. World Neurosurg 2023; 171: e404-e411
    CrossrefPubMedSuche in Google Scholar
  • 60 Trevisi G, Scerrati A, Rustemi O. et al. Does the timing of the surgery have a major role in influencing the outcome in elders with acute subdural hematomas?. J Pers Med 2022; 12 (10) 1612
    CrossrefPubMedSuche in Google Scholar
  • 61 Anis SB, Khan SA, Mitha R, Shamim MS. Craniotomy or craniectomy for acute subdural hematoma? Difference in patient characteristics and outcomes at a tertiary care hospital. Asian J Neurosurg 2022; 17 (04) 563-567
    Thieme ConnectPubMedSuche in Google Scholar
  • 62 Bullock MR, Chesnut R, Ghajar J. et al; Surgical Management of Traumatic Brain Injury Author Group. Surgical management of acute subdural hematomas. Neurosurgery 2006; 58 (03) S16-S24 , discussion Si-iv
    PubMedSuche in Google Scholar
  • 63 Beucler N, Sellier A, Joubert C. et al. Severe trauma patients requiring undelayable combined cranial and extracranial surgery: a scoping review of an emerging concept. J Neurosci Rural Pract 2022; 13 (04) 585-607
    CrossrefPubMedSuche in Google Scholar
  • 64 Beucler N, Sellier A, Joubert C. et al. Severe trauma patients requiring undelayable combined cranial and extra-cranial surgery: a proof-of-concept monocentric study. Mil Med 2022; 187 (9–10): 1127-1135
    CrossrefPubMedSuche in Google Scholar
  • 65 Zumkeller M, Behrmann R, Heissler HE, Dietz H. Computed tomographic criteria and survival rate for patients with acute subdural hematoma. Neurosurgery 1996; 39 (04) 708-712 ; discussion 712–713. . PMID: 8880762
    CrossrefPubMedSuche in Google Scholar
  • 66 Bartels RH, Meijer FJ, van der Hoeven H, Edwards M, Prokop M. Midline shift in relation to thickness of traumatic acute subdural hematoma predicts mortality. BMC Neurol 2015; 15: 220
    CrossrefPubMedSuche in Google Scholar