A Proposed Neurological Acute Subdural Hematoma Score

Abstract

Introduction

The prognosis of acute subdural hematoma (aSDH) remains poor. After identifying neurological factors associated with a poor prognosis for this condition in our series, we propose a predictive score for poor prognosis: " The Yaounde Neurological Acute Subdural Hematoma Score" (YN-aSDH Score).   

Methodology

This was a cross-sectional study carried out in the neurosurgery departments of Yaounde Central Hospital, the Yaounde Military Hospital, and the Yaounde General Hospital during the period from January 01, 2008, to December 31, 2018. The prognosis was considered poor for patients who died or were in a permanent vegetative state at discharge from the hospital. Four neurological factors of poor prognosis were retained. Based on their association with a poor prognosis, we proposed a predictive score (YN-aSDH Score).

Result

The YN-aSDH score was scored as follows: GCS 3-8 = 3, GCS 9-12 = 2, GCS 13-15 = 1; Preoperative hemiplegia: present = 2, absent = 0, Postoperative convulsions: present = 1, absent = 0, Recurrence of aSDH: present = 1, absent = 0. The maximum possible score = 7 while the minimum score = 1.        

Interpretation: All patients who died or were in a vegetative state had a score greater than or equal to 3. 

Conclusion: A YN-aSDH between 3 and 7 predicts a poor prognosis. Its reliability and validity should be confirmed in larger prospective studies.