| Peer-Reviewed

Surgical Outcome of Expansile Duraplasty VS Multiple Dural Slits in Patients with Traumatic Acute Sub-Dural Hematoma in Terms of Glasgow Outcome Scale (GOS)

Received: 8 August 2022     Accepted: 12 October 2022     Published: 29 October 2022
Views:       Downloads:
Abstract

Objective: To compare the post-operative Glasgow Outcome Scale (GOS) of expansile duraplasty vs multiple dural slits in patients with traumatic Acute Sub Dural Hematoma. Duration: 20.11.2019 to 19.05.2002 (6months). Setting: Department of Neurosurgery, PIMS, Islamabad. Subject and Methods: The study design was a randomized control trial. A total of 70 patients presented to our department with traumatic brain injury (acute subdural hematoma) divided into two groups through the lottery method and meeting our inclusion criteria were enrolled through the nonprobability consecutive sampling technique. Results: Out of 70 patients, Group A (wide dural wide flap and duraplasty) was found in 15 (42.86%) patients, while Group B (multiple dural slits) was found in 04 (11.43%) patients (p-value=0.003).Conclusion: This study concluded that favorable outcome is better in such cases who underwent expansile duraplasty in patients with traumatic acute sub dural hematoma as compared to patients who underwent multiple dural slits in traumatic acute sub dural hematoma. Therefore, we recommend that expansile duraplasty should be used as a prime technique in patients with traumatic acute sub dural hematoma for favorable outcome in terms of Glasgow Outcome and to reduce the overall morbidity and mortality of our general population presented with traumatic brain injury (traumatic acute sub dural hematoma).

Published in International Journal of Neurosurgery (Volume 6, Issue 2)
DOI 10.11648/j.ijn.20220602.21
Page(s) 94-98
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Traumatic Brain Injury, Subdural Hematoma, Duraplasty, Expansile Duraplasty, Multiple Dural Slits, Glasgow Outcome Scale

References
[1] Umerani MS, Abbas A, Sharif S. Traumatic brain injuries: experience from a tertiary care centre in Pakistan. Turkish neurosurgery. 2014; 24 (1): 19-24.
[2] Khan B, Afridi EA, Khan B, Khan SA, Aurangzeb A, Khan AA, Khan W, Bhatti SN. Decompressive Craniectomy for Acute Subdural Haematoma With Expansile Duraplasty Versus Dural-Slits. Journal of Ayub Medical College Abbottabad. 2016 Jun 1; 28 (2): 285-8.
[3] Prahaladu P, Satyavara Prasad K, Rajasekhar B, Satyanarayana Reddy K. Clinical Study of Acute Subdural Haematoma—A Level I Trauma Care Centre Experience. International Journal of Research in Medical Sciences. 2017; 5: 857- 62.
[4] El Refaee E, Elsayed A, El-Fiki A, El Shitany H. Decompressive Craniotomy and Fast-Track Duraplasty in Acute Subdural Hematomas. Open Journal of Modern Neurosurgery. 2018 Dec 7; 9 (1): 35-42.
[5] Khan AA. Comparison of Decompressive Craniectomy and Multi-Dural Stabs with Decompressive Craniectomy and Open-Dural Flap Method, in the Treatment of Acute Subdural Hematomas. J Rawalpindi Med Coll. 2017; 21 (4): 339-43.
[6] Abbas G, Khan RU, Zubair UB, Bhatti SN. Comparison of Outcome of Decompressive Craniectomy with Wide Dural Flap Duraplasty Versus Dural Slits in the Management of Post Traumatic Acute Subdural Hematoma in Terms of Post-operative CSF Leak. Pakistan Journal Of Neurological Surgery. 2019 Sep 26; 23 (3): 163-9.
[7] Uddin K, Hossain SS, Salam MA, Haque MA, Rahman MM, Kabir AG, Talukder MM. Comparison of Decompressive Craniotomy by Wide Opening of Dura with Multidural Fenestrations Technique among Acute Subdural Hematoma Patients: A Randomized Control Trial. Journal of National Institute of Neurosciences Bangladesh. 2018 Dec 10; 4 (2): 75-81.
[8] Ransohoff J, Benjamin MV, Gage EL Jr, Epstein F. Hemicraniectomy in the management of acute subdural hematoma. J Neurosurg. 1971; 34 (1): 70-6.
[9] Kjellberg RN, Prieto A Jr. Bifrontal decompressive craniotomy for massive cerebral edema. J Neuro-surg. 1971; 34 (4): 488-93.
[10] Venes JL, Collins WF. Bifrontal decompressive craniectomy in the management of head trauma. J Neursurg. 1975; 42 (4): 429-33.
[11] Aarabi B, Hesdorffer DC, Ahn ES, Aresco C, Scalea TM, Eisenberg HM. Outcome following decompressive craniectomy for malignant swelling due to severe head injury. J Neursurg. 2006; 104 (4): 469-79.
[12] Qiu W, Guo C, Shen H, Chen K, Wen L, Huang H, et al. Effects of unilateral decompressive craniectomy on patients with unilateral acute post-traumatic brain swelling after severe traumatic brain injury. Crit Care. 2009; 13 (6): R185.
[13] Chibbaro S, Di Rocco F, Mirone G, Fricia M, Makiese O, Di Emidio P, et al. Decompressive craniectomy and early cranioplasty for the management of severe head injury: a prospective multi-center study on 147 patients. World Neurosurg. 2010; 75 (3-4): 558-62.
[14] Ban SP, Son YJ, Yang HJ, Chung YS, Lee SH, Han DH. Analysis of Complications Following Decompressive Craniectomy for Traumatic Brain Injury. J Korean Neurosurg Soc. 2010; 48 (3): 244-50.
[15] Tien HC, Cunha JR, Wu SN, Chughtai T, Tremblay LN, Brenneman FD, et al. Do trauma patients with a Glasgow Coma Scale score of 3 and bilateral fixed and dilated pupils have any chance of survival? J Trauma. 2006; 60 (2): 274-8.
[16] Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, D'Urso P, et al. Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med. 2011; 364 (16): 1493-502.
[17] Khan B, Afridi EAK, Khan B, Khan SA, Aurangzeb A, Khan AA, et al. Decompressive craniectomy for acute subdural haematoma with expansile duraplasty versus dural-slits. J Ayub Med Coll Abbottabad 2016; 28 (2): 285–8.
[18] Barthelemy EJ, Melis M, Gordon E, Ullman JS, Germano IM. Decompressive Craniectomy for Severe Traumatic Brain Injury: A Systematic Review. World Neurosurg. 2016; 88: 411-20.
[19] Bhat AR, Kirmani AR, Wani MA. Decompressive craniectomy with multi-dural stabs–a combined (SKIMS) technique to evacuate acute subdural hematoma with underlying severe traumatic brain edema. Asian journal of neurosurgery, 2013; 8 (1): 15.
Cite This Article
  • APA Style

    Nafees Ahmad Khan, Syed Arif Hussain, Umer Sajjad, Ghayur Abbas, Sajid Nazeer Bhatti. (2022). Surgical Outcome of Expansile Duraplasty VS Multiple Dural Slits in Patients with Traumatic Acute Sub-Dural Hematoma in Terms of Glasgow Outcome Scale (GOS). International Journal of Neurosurgery, 6(2), 94-98. https://doi.org/10.11648/j.ijn.20220602.21

    Copy | Download

    ACS Style

    Nafees Ahmad Khan; Syed Arif Hussain; Umer Sajjad; Ghayur Abbas; Sajid Nazeer Bhatti. Surgical Outcome of Expansile Duraplasty VS Multiple Dural Slits in Patients with Traumatic Acute Sub-Dural Hematoma in Terms of Glasgow Outcome Scale (GOS). Int. J. Neurosurg. 2022, 6(2), 94-98. doi: 10.11648/j.ijn.20220602.21

    Copy | Download

    AMA Style

    Nafees Ahmad Khan, Syed Arif Hussain, Umer Sajjad, Ghayur Abbas, Sajid Nazeer Bhatti. Surgical Outcome of Expansile Duraplasty VS Multiple Dural Slits in Patients with Traumatic Acute Sub-Dural Hematoma in Terms of Glasgow Outcome Scale (GOS). Int J Neurosurg. 2022;6(2):94-98. doi: 10.11648/j.ijn.20220602.21

    Copy | Download

  • @article{10.11648/j.ijn.20220602.21,
      author = {Nafees Ahmad Khan and Syed Arif Hussain and Umer Sajjad and Ghayur Abbas and Sajid Nazeer Bhatti},
      title = {Surgical Outcome of Expansile Duraplasty VS Multiple Dural Slits in Patients with Traumatic Acute Sub-Dural Hematoma in Terms of Glasgow Outcome Scale (GOS)},
      journal = {International Journal of Neurosurgery},
      volume = {6},
      number = {2},
      pages = {94-98},
      doi = {10.11648/j.ijn.20220602.21},
      url = {https://doi.org/10.11648/j.ijn.20220602.21},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.21},
      abstract = {Objective: To compare the post-operative Glasgow Outcome Scale (GOS) of expansile duraplasty vs multiple dural slits in patients with traumatic Acute Sub Dural Hematoma. Duration: 20.11.2019 to 19.05.2002 (6months). Setting: Department of Neurosurgery, PIMS, Islamabad. Subject and Methods: The study design was a randomized control trial. A total of 70 patients presented to our department with traumatic brain injury (acute subdural hematoma) divided into two groups through the lottery method and meeting our inclusion criteria were enrolled through the nonprobability consecutive sampling technique. Results: Out of 70 patients, Group A (wide dural wide flap and duraplasty) was found in 15 (42.86%) patients, while Group B (multiple dural slits) was found in 04 (11.43%) patients (p-value=0.003).Conclusion: This study concluded that favorable outcome is better in such cases who underwent expansile duraplasty in patients with traumatic acute sub dural hematoma as compared to patients who underwent multiple dural slits in traumatic acute sub dural hematoma. Therefore, we recommend that expansile duraplasty should be used as a prime technique in patients with traumatic acute sub dural hematoma for favorable outcome in terms of Glasgow Outcome and to reduce the overall morbidity and mortality of our general population presented with traumatic brain injury (traumatic acute sub dural hematoma).},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Surgical Outcome of Expansile Duraplasty VS Multiple Dural Slits in Patients with Traumatic Acute Sub-Dural Hematoma in Terms of Glasgow Outcome Scale (GOS)
    AU  - Nafees Ahmad Khan
    AU  - Syed Arif Hussain
    AU  - Umer Sajjad
    AU  - Ghayur Abbas
    AU  - Sajid Nazeer Bhatti
    Y1  - 2022/10/29
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijn.20220602.21
    DO  - 10.11648/j.ijn.20220602.21
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 94
    EP  - 98
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20220602.21
    AB  - Objective: To compare the post-operative Glasgow Outcome Scale (GOS) of expansile duraplasty vs multiple dural slits in patients with traumatic Acute Sub Dural Hematoma. Duration: 20.11.2019 to 19.05.2002 (6months). Setting: Department of Neurosurgery, PIMS, Islamabad. Subject and Methods: The study design was a randomized control trial. A total of 70 patients presented to our department with traumatic brain injury (acute subdural hematoma) divided into two groups through the lottery method and meeting our inclusion criteria were enrolled through the nonprobability consecutive sampling technique. Results: Out of 70 patients, Group A (wide dural wide flap and duraplasty) was found in 15 (42.86%) patients, while Group B (multiple dural slits) was found in 04 (11.43%) patients (p-value=0.003).Conclusion: This study concluded that favorable outcome is better in such cases who underwent expansile duraplasty in patients with traumatic acute sub dural hematoma as compared to patients who underwent multiple dural slits in traumatic acute sub dural hematoma. Therefore, we recommend that expansile duraplasty should be used as a prime technique in patients with traumatic acute sub dural hematoma for favorable outcome in terms of Glasgow Outcome and to reduce the overall morbidity and mortality of our general population presented with traumatic brain injury (traumatic acute sub dural hematoma).
    VL  - 6
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

  • Department of Neurosurgery, Provincial Headquarters Hospital, Gilgit Baltistan, Pakistan

  • Basic Health Unit Khazana, Peshawar, Health Department, Khyber Pakhtunkhwa, Pakistan

  • Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK

  • Neurosurgery Department, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

  • Sections