Comparison of Efficacy of Decompressive Craniectomy By Multiple Dural Stabs Versus Open Dural Flap For The Evacuation of Acute Subdural Hematoma

Objective: to study the functional outcome of the subjects of acute subdural hematoma subjected to decompressive craniectomy by multiple dural stabs versus open dural flap using the Glasgow outcome score. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Neurosurgery Combined Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2019. Methodology: Eighty patients with acute subdural hematoma were recruited for this study and equally divided into two groups. In Group-A, decompressive craniectomy was performed using multiple dural stabs, whereas patients of Group-B had open dural flap craniectomy. Results: The mean age of the patients was 30.9±9.98 years in Group-A and 31.2±8.9 years in Group-B. A comparison of functional outcomes based on the Glasgow Outcome Score on the 14th day showed that 62.5% of patients had an unfavourable outcome in Group-A, while 90.60% had the same in Group-B. On the other hand, 37.7% of Group-A patients had a favourable outcome, whereas 9.6% had a favourable recovery in Group-B (p-value : 0.001). Conclusion: Acute subdural hematoma treated with multiple dural stabs technique of decompressive craniectomy has a better outcome as compared to open dural flap technique in terms of functional status of the patient.