Volume 24, Issue 103, May - June, 2020

Impact of surgical evacuation on chronic Subdural Hematoma patients’ cognitive functions outcome

Osama Abdelsalam², Ashraf El Badry¹, Mohamed Abdelbary Matar¹, Ayman Abdelnaby²

¹Department of neurological surgery, Faculty of medicine, Mansoura University, Egypt
²Department of neurology, Faculty of medicine, Mansoura University, Egypt

ABSTRACT

Background: Chronic subdural haematoma (CSDH) patients represent one of common disease in neurosurgical practice. Those patients may suffer from various disabilities including intellectual function decline with or without motor deficit. Aim of the study: to address the reversible cognitive function improvement after burr hole evacuation of CSDH. Patients and Material: This prospective study of observation 55 CSDH patients who admitted to neurosurgery department in Mansoura Emergency Hospital in the period between January 2017 till January 2019. It includes 42 male, 13 female; patient’s age was ranging from 46-72 (mean age 67.1±4.6) years. Each patient cognitive performance was evaluated pre, postoperatively and after 8 weeks in Out Patient Clinic (OPC) by using MMSE. All cases had also pre and post-operative CT Head to document presence of CSDH. The surgical procedure for all cases was two burr holes evacuation. The data of clinical features, intellectual functions and images had been collected and analysed. Results: The presenting manifestation was impairment in intellectual functions in 34 cases (62%). The sever persistent headache was presenting symptom in 21 patients (38.1%), hemi or mono paresis as presenting symptom was in 19 cases (34.5%), the dysphasia was present in 7 cases (12.7%) and seizures in 5 cases (9.1%).there is statistically significant in CSDH patient’s cognitive performance improvement (p=0.00), headache (p=0.00), motor deficit (p=0.02) and speech dysphasia (p=0.38). Conclusion: The decline of intellectual functions represents the most common manifestation of CSDH patients in geriatric population which can be reversible after the simple surgical procedure. CSDH must be in deferential diagnosis of dementia in old age patients beside neurodegenerative disease. The neuro imaging is mandatory in such cases to eliminate presence of CSDH.

Keywords: Chronic subdural hematoma, cognitive impairment, burr hole, dementia, CSDH

Medical Science, 2020, 24(103), 1445-1451

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