Turkish Neurosurgery 2016 , Vol 26 , Num 5
The Comparison Between Surgical Procedure and Conservative Treatment in the Management of Traumatic Subdural Effusion
Dajiang XIE, Jixi XIE, Yingfeng WAN , Xuchen QI, Shuxu YANG
Zhejiang University, College of Medical Sciences, Sir Run Run Shaw Hospital, Department of Neurosurgery, Hangzhou, China DOI : 10.5137/1019-5149.JTN.11826-14.1 AIM: Traumatic subdural effusion (TSE) occurs following traumatic brain injury and may be treated by either conservative methods or surgical procedure commonly according to the patients’ clinical information. We aimed to compare the effective rate of effusion removal and the standardized morbidity ratio of poor prognosis of the two different treatments, and to discuss the future treatment methods possible.

MATERIAL and METHODS: We reviewed the clinical records of patients who were divided into two groups according to the treatment choices in our center, and the effective rate of effusion removal and the standardized morbidity ratio of poor prognosis were compared.

RESULTS: Eighty patients were identified, and divided into two groups: conservative treatment and surgical procedure group. The mean CRASH-CT predicted risk of mortality in two weeks and unfavorable outcome at six months was higher in the surgical procedure group compared with the conservative treatment group. Effective rate of effusion removal was observed in 57.1 % of conservative treatment group versus 88.5% of surgical procedure group (p=0.002). The standardized morbidity ratio of poor prognosis (observed/expected poor prognosis) was 0.56 (95 % CI: 0.32–0.80) for the conservative treatment group versus 0.25 (95 % CI: 18 0.08-0.42) for the surgical procedure group.

CONCLUSION: Conservative treatment and surgical procedure are used for the management of traumatic subdural effusion, and the former is used more commonly to treat the mildly affected patients than the latter one, but a surgical procedure may be more effective for the patients in poor clinical condition. Adequate evidence is required to clear the indications. Keywords : Traumatic subdural effusion, Conservative treatment, Surgical procedure

Corresponding author : Shuxu Yang, yangshuxu@2980.com