Related Experiment Video

Updated: Jul 4, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
10:34

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage

Published on: August 30, 2020

11.6K

Bilateral chronic subdural hematoma: what is the clinical significance?

Yu-Hua Huang1, Ka-Yen Yang, Tao-Chen Lee

  • 1Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. newlupin2001@yahoo.com.tw

International Journal of Surgery (London, England)
|May 28, 2013
PubMed

Insights

Bilateral chronic subdural hematoma (CSDH) presents differently than unilateral CSDH, with fewer neurological deficits but a higher recurrence rate. Early surgical decompression is recommended for bilateral CSDH to prevent deterioration.

Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Bilateral chronic subdural hematoma (CSDH) is a recognized condition with limited comparative data.
  • Understanding clinical differences is crucial for effective patient management.

Purpose of the Study:

  • To compare clinical characteristics between patients with bilateral and unilateral CSDH.
  • To identify differences in neurological outcomes, morbidity, mortality, and recurrence rates.

Main Methods:

  • Retrospective study of 98 patients with CSDH over two years.
  • Analysis of neurological outcomes, morbidity, mortality, and recurrence after burr hole craniostomy.
  • Comparison of clinical and neuro-imaging findings between unilateral and bilateral CSDH groups.

Main Results:

  • Bilateral CSDH occurred in 25.51% of patients.
  • Bilateral CSDH showed a lower incidence of hemiparesis but significantly greater midline shift and hematoma thickness.
  • The recurrence rate for bilateral CSDH (28.00%) was significantly higher than for unilateral CSDH (9.59%).

Conclusions:

  • Fewer focal neurological deficits in bilateral CSDH may delay diagnosis and treatment.
  • Early surgical decompression is advised for bilateral CSDH to prevent neurological decline due to thicker hematomas.
  • Clinicians should be aware of the increased risk of recurrence for bilateral CSDH post-craniostomy.
Abstract

Keywords:
BilateralBurr holeChronic subdural hematomaPrognosisRecurrence

More Related Videos

A Preclinical Controlled Cortical Impact Model for Traumatic Hemorrhage Contusion and Neuroinflammation06:50

A Preclinical Controlled Cortical Impact Model for Traumatic Hemorrhage Contusion and Neuroinflammation

Published on: June 10, 2020

2.3K
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model09:14

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

Published on: June 18, 2021

2.9K

Related Concept Videos

Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...