BACKGROUND Acute subdural haematoma is a common type of intracranial haematoma occurring from head injuries. It is frequently associated with cerebral contusion or laceration. It carries a high mortality and morbidity despite advanced care in the management of head injury. In the treatment of head injuries the subgroup of patients having acute subdural haematoma respond relatively poorly to the most vigorous treatment, both conservative and surgical which is most depressing. In our study our

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... is to have an insight into this problem. METHODS A series of 77 patients of acute subdural haematoma with GCS from 3-15 were evaluated. All patients had acute SDH with or without associated parenchymal lesions on CT scan. Patients expiring within six hours of admission were not included in this study. Results: Age of the patients ranged from 1-56 years; 50.6% patients were in their 3rd and 4th decades. While 59.74% of patients with age < 40 years survived, only 20.77% patients above 40 years survived and this difference was statistically significant (p<0.01). Out of total 77 patients, 62 (80.51%) survived. Number of patients operated for SDH were 5. Of them 4 survived and 1 died. CONCLUSION Adults in their 3rd and 4th decades of life are the commonest victims of acute SDH. Majority of the patients who had small SDH were treated conservatively and they responded to the treatment favourably. In our series of operations on acute SDH the time of surgery did not show any significant difference of outcome.