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Of 100 patients who required operation for severe head injury with acute subdural hematoma, 25 survived. Fourteen survivors recovered completely. Seventy-five patients died. Few factors distinguished the postinjury course of those who lived from that of those who did not. Advanced age, preoperative shock, large bilateral subdural hematomas, gross disruption of brain, and inadequate removal of hematoma through burr holes were more often associated with death. An accurate forecast of outcome was not possible from the preoperative neurologic signs. Consequently, we favor early diagnostic studies including angiography when time permits, thorough removal of the hematoma usually by craniotomy, and vigorous postoperative management often including angiography and a second operation.
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Accepted: October 10, 1973
☆This work was supported in part by Trauma Center Program Project Grant No. GM-18470 and NINDS Training Grant No. 5593.
© 1974 Published by Elsevier Inc.