title: Clinical profile of subdural hematomas: dangerousness of subdural subacute hematoma.
abstract: Subacute subdural hematomas are a poorly individualized nosological entity, often equated clinically to chronic subdural hematomas. Yet, their neurological deterioration which is usually rapid seems to distinguish them from chronic subdural hematomas. We wanted to show this dangerousness by establishing the clinically evolving profile of the three types of subdural hematomas. This was a prospective and retrospective study of 63 subdural hematoma (18 acute, 13 subacute, and 32 chronic) patients admitted between 2012 and 2014 in the neurosurgery unit of Lomé University Hospital. Hematomas were classified according to the elapsed time after head injury and blood density on CT. The main parameter studied was the evolution of the Glasgow Coma Score (GCS) in the 3 months following the trauma, enabling to establish an evolving profile of each type of hematoma. The average age of patients was 58.1 years for chronic subdural hematomas and 47.6 years for subacute subdural hematomas. Disease duration before admission was 13.1 days for chronic against 36.6 h for subacute hematoma. The clinical profile shows acute worsening within hours during the second week for patients with subacute hematoma, while it is progressive for patients with chronic hematoma. We noted two deaths, all victims of a subacute hematoma (one operated, one patient waiting for surgery). Iso-density hematoma on CT, especially in a young person, must be considered as a predictive factor of rapid neurological aggravation suggesting an urgent care or increased monitoring by paramedics.
authors.affiliation: Neurosurgery Unit, Sylvanus Olympio University Hospital, 08 BP: 8615, Lomé, Togo. kpelas77@yahoo.fr.
authors.forename: E
authors.initials: E
authors.lastname: Kpelao
authors.affiliation: Neurosurgery Unit, Sylvanus Olympio University Hospital, 08 BP: 8615, Lomé, Togo.
authors.forename: K A
authors.initials: KA
authors.lastname: Beketi
authors.affiliation: Neurosurgery Unit, Sylvanus Olympio University Hospital, 08 BP: 8615, Lomé, Togo.
authors.forename: A K
authors.initials: AK
authors.lastname: Moumouni
authors.affiliation: Neurosurgery Unit, Sylvanus Olympio University Hospital, 08 BP: 8615, Lomé, Togo.
authors.forename: A
authors.initials: A
authors.lastname: Doleagbenou
authors.affiliation: Radiology Unit, Kara University Hospital, Kara, Togo.
authors.forename: B
authors.initials: B
authors.lastname: Ntimon
authors.affiliation: Intensive Care Unit, Sylvanus Olympio University Hospital, Lomé, Togo.
authors.forename: P
authors.initials: P
authors.lastname: Egbohou
authors.affiliation: Intensive Care Unit, Sylvanus Olympio University Hospital, Lomé, Togo.
authors.forename: T
authors.initials: T
authors.lastname: Mouzou
authors.affiliation: Intensive Care Unit, Sylvanus Olympio University Hospital, Lomé, Togo.
authors.forename: K
authors.initials: K
authors.lastname: Tomta
authors.affiliation: Intensive Care Unit, Sylvanus Olympio University Hospital, Lomé, Togo.
authors.forename: D H
authors.initials: DH
authors.lastname: Sama
authors.affiliation: Trauma-Orthopaedics Unit, Sylvanus Olympio University Hospital, Lomé, Togo.
authors.forename: A
authors.initials: A
authors.lastname: Abalo
authors.affiliation: Trauma-Orthopaedics Unit, Sylvanus Olympio University Hospital, Lomé, Togo.
authors.forename: A
authors.initials: A
authors.lastname: Walla
authors.affiliation: Trauma-Orthopaedics Unit, Sylvanus Olympio University Hospital, Lomé, Togo.
authors.forename: A
authors.initials: A
authors.lastname: Dossim
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D006259:Craniocerebral Trauma / Q000601:surgery*; D003617:Dangerous Behavior; D005260:Female; D006408:Hematoma, Subdural / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Clinical profile; Subdural hematomas