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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.

Objective: To determine the efficacy of mini-craniotomy for evacuation of mix-density subdural hematoma in terms of early clinical outcome. Study Design: Quasi-experimental study. Place and Duration of Study: Neurosurgery Department, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2020. Methodology: Eighty patients with mixed-density subdural hematoma were included in the study. All were subjected to minicraniotomy under general anaesthesia. Post-operative Glasgow Coma Scale (GCS) was monitored and compared with the preoperative Glasgow Coma Scale (GCS) to see the early clinical outcome of the patients. Results: Out of 80 patients with mixed-density subdural, 38(47.5%) were females, whereas 42(52.5%) were males. The mean age of the patients was 70.9±6.98 years. Improvement in Glasgow Coma Scale (GCS) after 24hrs showed that 68(85%) patients had a favourable outcome, while 12(15%) had the same condition post-operatively. Conclusion: Mini-craniotomy is a suitable surgical procedure for the treatment of mixed-density subdural hematoma.

Objective: To compare the efficacy of titanium mesh to autologous bone grafting in cranioplasty and assessing complications like seroma and abscess formations and subjective measures of pain. Study Design: Comparative cross-sectional study. Place and Duration of Study: Neurosurgery department, CMH Rawalpindi, from Aug 2017 to Dec 2018. Methodology: Twenty patients (Women=12, Men=8) were randomly assigned to Titanium Mesh (TM) group and 20 patients (Women=7, Men=13) to Autologous Bone Graft (ABG) group. All were subjected to cranioplasty using Titenium Mesh and Autologous Bone Graft procedures to assess cranial seroma and abscess formation and pain. Results: Comparison of pain on day 3 showed seven (35%) patients in titenium mesh group experienced pain compared to 14 (70%) patients in the autologous bone graft group, which was statistically significant (p