CC BY 4.0 · Indian Journal of Neurotrauma 2023; 20(02): 089-100
DOI: 10.1055/s-0041-1739475
Original Article

Clinical and Laboratory Markers in Determination of Treatment Modalities and Short-Term Prognosis in Patients with Traumatic Acute Subdural Hematoma: Original Study

1   Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
Ulas Yuksel
1   Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
Alemiddin Ozdemir
1   Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
Ibrahim Umud Bulut
1   Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
Mustafa Ogden
1   Department of Neurosurgery, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
› Author Affiliations
Funding None.


Objective In patients with traumatic acute subdural hematoma (ASH), it has not been yet fully elucidated which patients can benefit from surgery or from clinical follow-up. This study was constructed to predict treatment modality and short-term prognosis in patients with ASH using their clinical, radiological, and biochemical laboratory findings during admission to hospital.

Methods Findings of patients with ASH determined on their CT scan between 2015 and 2018 were evaluated. Patients were grouped in terms of ASH-FOL (patients followed-up without surgery, n = 13), ASH-OP (patients treated surgically, n = 10), and ASH-INOP (patients considered as inoperable, n = 5) groups. They also were divided into “survived (n = 14)” and “nonsurvived (n = 14)” groups.

Results ASH developed as a result of fall from a height in 15 patients and traffic accidents in 13 patients. In deciding for surgery, it was determined that Glasgow coma scale (GCS) scores < 8, midline shift (MLS) level > 5 mm, MLS-hematoma thickness ratio > 0.22, leukocyte count > 12730 uL, and presence of anisocoria could be used as predictive markers. It was determined that GCS scores < 8, hematoma thickness value > 8 mm, and the presence of anisocoria could be considered as biomarkers in prediction of mortality likelihood.

Conclusion It could be suggested that GCS scores, MLS level, MLS-hematoma thickness ratio, presence of anisocoria, and leukocyte count value could help in determination of the treatment modality in patients with ASH. Additionally, GCS scores, hematoma thickness value, and presence of anisocoria could each be used as a marker in the prediction of early-stage prognosis and mortality likelihood of these patients.

Informed Consent

Informed consent was obtained from all individual participants or their parents who were included in this study.

Authors' Contributions

All of the authors declare that they have all participated in the design, execution, and analysis of the paper, and that they have approved the final version:

- Concept and design: B.B.

- Definition of intellectual content: B.B., M.O.

- Literature search: B.B., U.Y.

- Data acquisition: A.O., I.U.B.

- Data analysis: B.B., M.O., U.Y.

- Statistical analysis: B.B.

- Manuscript preparation: B.B.

- Manuscript editing: M.O.

- Manuscript review: B.B., M.O., U.Y.

Publication History

Received: 08 June 2021

Accepted: 22 July 2021

Article published online:
07 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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