The relationship between Glasgow coma/outcome scores and abnormal CT scan findings in chronic subdural hematoma

Objectives: Chronic subdural hematoma (CSDH) is one of the most frequent types of intracranial hemorrhage. We evaluated the independent association between abnormal CT findings in CSDH and both Glasgow coma score (GCS) on admission as a measure of consciousness and Glasgow outcome score (GOS) at discharge as a measure of outcome.

Patients and methods: One hundred and sixteen consecutive patients with CSDH were studied. The variables considered were brain atrophy, hydrocephalus, hematoma location, midline shift, and hematoma density. After univariate analysis and evaluation of the role of age as a confounder in bivariate analysis, variables that had significant association with Glasgow scores were included in the final multivariate model.

Results: Brain atrophy as the only variable with significant independent association (p <0.001; OR = 77.214; 95% CI = 8.336-715.212) with unfavorable outcome as defined by GOS. On the other hand, hydrocephalus (p = 0.042; OR = 6.503; 95% CI = 1.072-39.449) and higher hematoma densities (p = 0.027; OR = 2.597; 95% CI = 1.116-6.024) independently and significantly increased the risk of severe consciousness impairment when the group with GCS > 12 was considered as the reference category.

Conclusion: Brain atrophy independently increases the risk of unfavorable outcome after CSDH. Hydrocephalus and higher hematoma densities independently increase the risk of severe consciousness impairment after CSDH. (c) 2006 Elsevier B.V. All rights reserved.