Introduction Chronic subdural hematoma (CSDH) cases are among the most frequently diagnosed and surgically performed intracranial hemorrhage cases in neurosurgery clinics. A complete correlation between hematoma thickness and clinical status in these cases cannot be established. 1-3 Since the symptoms are usually atypical, non-specific, and slow-progressing, radiological diagnoses can be made in the late period. Atypical complaints are defined as dizziness and decreased daily activities, not neurological deficits related to raised intracranial pressure. Most of the cases are diagnosed after non-comatose clinical status. 4 As most of these patients are of advanced age, their quality of life is inevitably lower than the quality of life of younger patients due to age and chronic diseases. For the same reasons, surgical comorbidity is expected to be high. 4-6 Complete improvement in quality of life is not always expected in the postoperative period. Karnofsky’s scale is one of the rational markers for evaluating general health status and quality of life, especially in elderly patients. 5,7-10 The pre- and postoperative Karnofsky’s score in patients with CSDH allows the quantitative evaluation of the operation type decision and postoperative recovery. In this study, we aimed to show the results of pre- and post-operative status with Karnofsky scoring. With this method, it is aimed to show that it can be a guide in the selection of the surgical technique to be applied to the cases in the Evaluation of Karnofsky Performance Scale as a Postsurgical Prognosis Criteria in Chronic Subdural Hematoma Cases: Discordance Between Clinical and Radiological Outcomes Ziya Asan 1* ID , Sercan Eroglu 2 , Aydan Koysuren 3 , Sezai Durmaz 2 1 Department of Neurosurgery, Kirsehir Ahi Evran University, Faculty of Medicine, Kirsehir, Turkey 2 Department of Emergency Medicine, Kirsehir Ahi Evran University, Faculty of Medicine, Kirsehir, Turkey 3 Department of Neurology, Kirsehir Training and Research Hospital, Kirsehir, Turkey Abstract Background: Chronic subdural hematoma (CSDH) may cause neurological deficits as well as adverse effects on the patient’s general health status. Although CSDH cases are diagnosed in the advanced age group with a very high rate, clinical findings may not be related only to CSDH. The aim should be related to clinical recovery rather than radiological recovery for these cases. We aimed to evaluate Karnofsky’s score as a measurement criterion of postoperative clinical outcomes in patients with CSDH. Methods: Cases operated for the diagnosis of CSDH were defined retrospectively. The cases that had been operated with this diagnosis were identified by examining the institution database records. Karnofsky scores equivalent to clinical status were performed by examining patient files. Karnofsky scoring before the symptomatic period was determined and compared with the Karnofsky score belonging to the late postoperative period. The clinical and radiological findings of the preoperative and postoperative periods were compared. Independent samples t test was used to reveal the difference between the two groups. Results: Data of 184 cases were evaluated. Seventy-three cases were operated on the left, 51 cases on the right, and 60 cases bilaterally with the diagnosis of CSDH. Burrhole exploration was performed in 119 cases, and a craniotomy was performed in 65 cases. Although a significant decrease in hematoma thickness was detected radiologically in cases operated with the craniotomy method, a more significant improvement was observed in Karnofsky’s score in cases operated with the burrhole method. In younger patients, improvement in Karnofsky’s score was significantly higher. Conclusion: The main aim should be to improve clinical status rather than radiological improvement in the treatment of CSDH cases. In the surgical treatment of these cases, it is possible to encounter a high rate of complications depending on age. It is possible to evaluate the postoperative status rationally with Karnofsky scoring. According to the preoperative Karnofsky scoring, deciding on the surgical technique may help reduce complications. Keywords: Chronic subdural hematoma; Intracranial hemorrhage; Karnofsky performance status; Subdural hematoma; Subdural hematoma surgery. Int Clin Neurosci J. 2023;10:e3 International Clinical Neuroscience Journal *Correspondence to: Ziya Asan, Email: ziyaasan@gmail.com © 2023 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. doi:10.34172/icnj.2023.03 Citation: Asan Z, Eroglu S, Koysuren A, Durmaz S. Evaluation of karnofsky performance scale as a postsurgical prognosis criteria in chronic subdural hematoma cases: discordance between clinical and radiological outcomes. Clin Neurosci J. 2023;10:e3. doi:10.34172/icnj.2023.03. Original Article Received: September 28, 2022 Accepted: December 15, 2022 Published online February 10, 2023