Volumetric Analysis of Subdural Haemorrhage: An Autopsy Based Study

Introduction: Subdural haemorrhage (SDH) is the 2^nd most common form of intracranial haemorrhage. Subdural haemorrhage is found in 26–30 % of serious head injury cases & is among the most frequent injuries seen by neurosurgeons.

Materials and Methods: 42 Cases of head injury having subdural haemorrhage were selected from the autopsies conducted at the Central morgue, Department of F.M.T, S.C.B Medical College and Hospital Cuttack, Odisha during the period from September 2011 -August 2013.

Results: Among the 42 cases studied, males out numbered females (80.95% Vs 19.04%, a ratio of 4.2: 1). The highest number of victims who suffered fatal traumatic SDH was in the age group of 21–50 years with a mean of 41.84 years i.e. in 30 (71.42%) cases. The least incidence was observed at extremes of ages i.e. in 3(7.14%) cases. We observed a range of 15 ml to 200 ml of fatal SDH volume with an overall mean volume of 60.95ml. The mean SDH volume among the young adults (21–40 years) with that of older people (>60 years) it was found to be 56.04 ml Vs 91.33 ml. It was observed that SDH is found associated with other vascular injuries like Subarachnoid haemorrhage (SAH), Extradural Haemorrhage (EDH), Intraventricular Haemorrhage (IVH), Intracerebral Haemorrhage (ICH) in 36 (85.71%) cases and isolated (pure) SDH is found only in 6 (14.29%) cases. When SDH was associated with other intracranial haemorrhages maximum death occurred in between 12 to 24 hours i.e. 13(36.11%) cases. Out of 25 cases of acute SDH maximum death occurred at about 24 hours i.e. 10 (40%) cases and among subacute cases maximum death occurred at about 5 days i.e. 7 (41.18%) cases. Overall 27 (64.2%) cases were associated with SAH, 16 (38.1%) cases with ICH, 12 (28.57%) cases with EDH and 5 (11.9%) cases with IVH. The difference of autopsy SDH volume and CT Scan SDH volume was found to be minimum of2.5 and 3 ml and maximum of200 ml.