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Cha, Kim, Lee, Moon, and Cho: The Clinical Course of Subdural Hygroma with Head Injury
Clinical Article

Korean J Nutr 2013;9(2):125-130.

Published online: 20 October 2013

DOI: https://doi.org/10.13004/kjnt.2013.9.2.125

The Clinical Course of Subdural Hygroma with Head Injury

Kyung Han Cha, MD, Chang Hyun Kim, MD, PhD, Ho Kook Lee, MD, PhD, Jae Gon Moon, MD, PhD, Tack Geun Cho, MD

Department of Neurosurgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea

Address for correspondence: Chang Hyun Kim, MD Department of Neurosurgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 150-950, Korea Tel: +82-2-829-5175, Fax: +82-2-833-0219 E-mail: nskch@hallym.or.kr

Received 2 September 2013       Revised 7 October 2013       Accepted 7 October 2013

Copyright © 2013 The Korean Nutrition Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Traumatic subdural hygroma (T-SDG) has been generally treated using conservative management rather than surgical methods. This study was performed to evaluate the clinical course of T-SDG with radiologic studies.

Methods

A retrospective study was conducted among patients diagnosed with T-SDG from January 2011 to December 2011. The patients were categorized into two groups. Group A has the widest width of T-SDG below 8 mm, Group B more than 8 mm. Computed tomography (CT) and magnetic resonance imaging (MRI) were carried out in both groups.

Results

Seventy-four patients were confirmed with T-SDG and were grouped as follows: 44 patients in Group A and 30 patients in Group B. There was no significant difference in age and sex ratio between group A and B. It took more time to resolve T-SDG in Group B (95.2±86.4 days) than Group A (14.4±6.7)(p＜0.001). However, no significant difference was observed in the Glasgow Coma Scale (GCS) between the groups. In 10 patients of Group B, T-SDG developed into chronic subdural hematoma and one of these patients underwent surgery.

Conclusion

Most T-SDGs were resolved after some period in this study. Surgery does not seem to be necessary in resolving T-SDG.

Keywords: Head injury, Traumatic subdural hygroma, Chronic subdural hematoma

References

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FIGURE 1.
CT findings of representative cases. In a group A patient (A and B) the maximum width of T-SDG is below 8 mm whereas it is more than 8 mm in group B (C and D). T-SDG: traumatic subdural hematoma.
kjn-9-125f1.tif
FIGURE 2.
The patient of T-SDG who changed to chronic subdural hematoma and was treated by surgical management. He had undergone surgical removal of epidural hematoma (EDH) in second hospital day. A: Post-operative day (POD) 1. B: POD 10. C: POD 27. D: POD 38. E: POD 47. F: POD 90. G: POD 118.
kjn-9-125f2.tif
TABLE 1.
Age distribution of patients with T-SDG
Age distribution Number of patients (%)
Group A Group B Total
0–9 0 (0) 0 (0) 0 (0)
10–19 2 (2.7) 0 (0) 2 (2.7)
20–29 2 (2.7) 3 (4.1) 5 (6.8)
30–39 8 (10.8) 2 (2.7) 10 (13.5)
40–49 5 (6.8) 1 (1.4) 6 (8.1)
50–59 8 (10.8) 7 (9.5) 15 (20.3)
60–69 10 (13.5) 6 (8.1) 16 (21.6)
70–79 5 (6.8) 7 (9.5) 12 (16.2)
80–89 4 (5.4) 4 (5.4) 8 (10.8)

T-SDG: traumatic subdural hygroma

TABLE 2.
Main diagnosis of patients with T-SDG
  Number of patients (%)
Group A Group B Total
T-SDH 9 (12.2) 14 (18.9) 23 (31.1)
Diffuse cerebral or cerebellar contusion 16 (21.6) 5 (6.8) 21 (28.4)
EDH 13 (17.6) 6 (8.1) 19 (25.7)
Other intracranial or head injury 3 (4.1) 1 (1.4) 4 (5.4)
T-SAH 1 (1.4) 2 (2.7) 3 (4.1)
Skull and facial bone fracture 1 (1.4) 1 (1.4) 2 (2.7)
Concussion 1 (1.4) 1 (1.4) 2 (2.7)

T-SDG: traumatic subdural hygroma, T-SDH: traumatic subdrural hematoma, EDH: epidural hematoma, T-SAH: traumatic subarachnoid hemorrhage

TABLE 3.
Cause of trauma in patients with T-SDG
  Number of patients (%)
Group A Group B Total
Traffic accident 14 (18.9) 11 (14.9) 25 (33.8)
Slip down 6 (8.1) 9 (12.2) 15 (20.3)
Rolling down at stairs 10 (13.5) 4 (5.4) 14 (18.9)
Unknown of origin 9 (12.2) 2 (2.7) 11 (14.9)
Fall down 3 (4.1) 3 (4.1) 6 (8.1)
Assault 1 (1.4) 1 (1.4) 2 (2.7)
Be hit 1 (1.4) 0 (0) 1 (1.4)

T-SDG: traumatic subdural hygroma

TABLE 4.
Sex, age, the time for the resolving T-SDG and GCS at admission between Group A and B
  Group A Group B p-value
Total patients 44 30 NC
Male/Female 33/11 25/5 0.393
Mean age 54.0±18.1 62.1±18.6 0.067
Mean days for the resolving T-SDG 14.4± 6.7 95.2±86.4 ＜0.001
GCS score at admission 13.3± 3.0 13.4± 3.2 0.803
GCS score at discharge 14.1± 2.5 14.1± 2.4 0.988
The development of T-SDG after intracranial operation (%) 7 (15.9) 5 (16.7) 0.931
Change to the CSDH (%) 0 (0) 10 (33.3) ＜0.001
Change to the CSDH/total T-SDG (%) T-SDG: traumatic subdural hygroma, Group A: slight observati 10/74 (13.5) ion group, Group B: close observation gr NC oup, GCS: Glasgow

T-SDG: traumatic subdural hygroma, Group A: slight observation group, Group B: close observation group, GCS: Glasgow Coma Scale, CSDH: chronic subdural hematoma, NC: not checked

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