KẾT QUẢ ĐIỀU TRỊ PHẪU THUẬT MÁU TỤ DƯỚI MÀNG CỨNG MẠN TÍNH TẠI BỆNH VIỆN ĐA KHOA BẮC NINH SỐ 1

Abstract

Objective: Describe clinical and CT characteristics and evaluate surgical outcomes of chronic subdural hematoma (cSDH) from Jan‑2024 to Aug‑2025. Methods: Retrospective–prospective case series of 114 patients undergoing burr‑hole irrigation and closed drainage. Clinical, CT, anesthetic, complications, and GOS outcomes were analyzed (SPSS 26.0). Results: Mean age 68.33 ± 14.55 (20–99); males 81.6%. Etiology: domestic falls 47.4%, traffic 20.2%, unknown 32.5%. Admission GCS 13–15 in 78.9%. CT: left 47.4%, right 36.0%, bilateral 16.7%; isodense 51.8%, mixed‑density 36.0%; thickness 11–20 mm 46.5%, >20 mm 43.0%; midline shift >10 mm 44.7%. Intravenous anesthesia 86.0%. Post‑op GCS 13–15 rose to 99.1% with marked symptom relief (headache 90.4%→23.7%, vomiting 43.9%→0%, motor deficit 50.9%→0.9%). Complications: subdural hygroma 37.7%, pneumocephalus 21.9%, rebleeding 4.4%, infection 0.9%. Hospital stay 9.3 ± 2.8 days. At 2 months, good recovery 80.7%, moderate 14.0%, poor 2.6%, vegetative 0.9%, death 1.8%; GOS 4–5 in 94.7%. Conclusion: Most patients with cSDH were elderly males, commonly presenting with headache, memory disturbance, and motor weakness; CT typically showed isodense/mixed‑density hematomas with midline shift >10 mm. Burr‑hole irrigation with closed drainage achieved significant clinical improvement, high rates of good recovery, and low complication rates.