title: Subdural hematomas: an analysis of 1181 Kashmiri patients.
abstract: BACKGROUND
  We endeavored to analyze patients of subacute and chronic subdural hematomas studied in a 4-year period at the Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India.
  
  
  METHODS
  The study was a retrospective analysis of 1181 patients of subdural hematomas. Demographic characteristics, clinico-radiologic features, operative modalities, and outcome were studied. Acute subdural hematomas were excluded from the study.
  
  
  RESULTS
  The mean age was 60.4 ± 12.4 and males outnumbered females. Chronic subdural collections were more common than subacute subdural hematomas and left side predominated. Two burr holes with closed-system drainage was used in most patients. Incidence of postoperative seizures is very low. Overall recurrence rates were low; however, multilocular hematomas had the highest incidence of recurrence. Morbidity and mortality were 7.53% and 2.96%, respectively. Preoperative neurologic grade correlated with outcome.
  
  
  CONCLUSIONS
  Subdural hematomas are common in elderly males. Preoperative neurologic grade dictates the outcome. Multilocular hematomas have a higher chance of recurrence. Craniotomy should be reserved for recurrent hematomas, and there may be a scope of craniotomy for multilocular chronic subdural hematomas at the outset. Antiepileptic prophylaxis is not routinely recommended.
authors.affiliation: Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India. nkhursh@rediffmail.com
authors.forename: Khursheed
authors.initials: K
authors.lastname: Nayil
authors.forename: Altaf
authors.initials: A
authors.lastname: Ramzan
authors.forename: Arif
authors.initials: A
authors.lastname: Sajad
authors.forename: Sheikh
authors.initials: S
authors.lastname: Zahoor
authors.forename: Abrar
authors.initials: A
authors.lastname: Wani
authors.forename: Furqan
authors.initials: F
authors.lastname: Nizami
authors.forename: Masood
authors.initials: M
authors.lastname: Laharwal
authors.forename: Altaf
authors.initials: A
authors.lastname: Kirmani
authors.forename: Rashid
authors.initials: R
authors.lastname: Bhat
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D006259:Craniocerebral Trauma / Q000150:complications; D003399:Craniotomy; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D019635:Neurosurgical Procedures; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants