Outcome of Endoscopic Management of Chronic Subdural Haematoma: A Retrospective Study

Abstract

Introduction: Chronic Subdural Haematoma (CSDH) is a condition with a collection of liquefied blood in the subdural space, which usually develops at least three weeks after an injury. Endoscopic evacuation of CSDH is a minimally invasive technique that has been shown to be effective in reducing the need for surgical dissection. Aim: To evaluate the outcome of endoscopic evacuation for CSDH. Materials and Methods: This retrospective study was conducted at the Department of Neurosurgery, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India and its affiliated hospitals from January 2021 to December 2022. All patients with CSDH on non contrast CT were included, except those with incomplete records, organised CSDH, secondary CSDH within six months of neurosurgery or meningitis, and those with an injury-to-procedure interval of less than 15 days. At admission, socio-demographic data (age, gender), clinical variables (headache, forgetfulness, hemiparesis, giddiness, speech difficulties), and co-morbidities were recorded. Pre and post-assessment were done by Glasgow Coma Scale (GCS). Descriptive statistics was used and results were expressed in terms of frequency and percentages. Results: A total of 20 patients with unilateral CSDH (predominantly on the left-side) were included, among which 16 were males and 4 females with a mean age of 64.45 years. The most common presenting complaints were headaches, forgetfulness, and unilateral weakness. Most patients had a GCS score of 14-15, and four had co-morbidities such as diabetes and hypertension. No brain tissue injury was observed during the endoscopic evacuation, and all patients achieved complete recovery (GCS score: 15) without any recurrence, infection, fresh bleeding, or brain or membrane injury. Rapid brain expansion occurred in 16 patients; Subdural Drains (SDD) was kept for five days in four patients. Conclusion: Endoscopic evacuation of CSDH is a safe and effective technique for improving clot removal and reducing the recurrence rate.