Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Blood gathers between the inner layer of the dura mater and the arachnoid mater. Usually resulting from tears in bridging veins which cross the subdural space, subdural hemorrhages may cause an increase in intracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. A subdural effusion is a collection of cerebrospinal fluid
OBJECTIVE:
To gate an opinion about the types of surgical procedures which had been done for the collected cases into 2 centers in Baghdad
METHODS:
This is a prospective study conducted at 2 Neurosurgical Hospitals in Baghdad, between September 2012 to December 2013, on 21 children and infants of subdural collection of fluid excluding abscess ages ranging from 40 days to 13 years . Clinical data was collected including symptoms and signs, in addition to assessment of radiological picture and subdural tab and diagnostic burr hole proved the diagnosis .treatment ranged from conservative to surgical interference included burr hole ,subdural peritoneal shunt and craniotomy. condition of the patients during discharge from the hospital was evaluated
RESULTS:
In this study , the higher percentage of patient were under the age of one year. no great difference in the sex of patients , disturbance of consciousness was the more type of presentation , unilateral subdural collections were more than bilateral collections. only 12 patients had surgical interference , of these 12 the majority had subdural peritoneal shunt , which seemed to be the most convenient procedure in chronic cases but in acute cases burr holes were the most convenient procedure. craniotomy was also used in treating chronic cases.
CONCLUSION :
Most of the patient were under one year old , brain ct scan was the diagnostic procedure , brain ultrasound was also useful in diagnosis of subdural collection. the most convenient surgical treatment in acute cases was the burr holes and in chronic cases was the subdural -peritoneal shunt , and to arrange for surgical interference when decided as early as possible to gate better outcome