Anum Wahab, Inamullah Asghar, Muhammad Abdur Rehman, Taimoor Anwar, Muhammad Akmal Hussain.
Comparison of the efficacy of multi dural stab craniectomy with open dural flap craniectomy in patients having acute subdural hematoma.
Pak J Neuro Surg Jan ;26(1):1-9.

Background/Objective:  We compared the efficacy of multi-dural stab craniectomy with open dural flap craniectomy in patients having acute subdural hematoma. Materials and Methods:  A randomized controlled trial was conducted in the Department of Neurosurgery, Allied hospital, Faisalabad. 70 patients having acute subdural hematoma were included. All of the patients were randomized in two groups: group A received a multi-dural stab craniectomy, while group B received an open dural flap craniectomy. Efficacy was assessed after 3 months of treatment in terms of a good recovery. Results:  Out of 70 patients, the mean age was 34.51 ± 8.712 years. Because of similar age and presenting GCS, the data show a non-significant difference in clinical outcomes between patients undergoing multi dual stab and open dural flap operations. However, a significant difference between the clinical results occurred at 3 months after the surgery (p-value 0.004). The efficacy of the multi-dural stab procedure was significantly higher from the open dural flap surgery (p-Value 0.006). The efficacy of the multi-dural stab surgery was significantly higher in the under 35 years age group of patients compared to open dural flap surgery. The results highlight those better results were seen in both surgeries when the presenting GCS of patients was higher (GCS= 6 – 8) compared to poor outcomes in patients with GCS of less than 5/15. Conclusion:  Multi-dural stabs are a safer alternative to the open dural flap for removing acute SDH with satisfactory recovery.

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