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The Predicting Factors for Recurrence of Chronic Subdural Hematoma Treated with Burr Hole and Drainage
Dae Hyo Song1, Young Soo Kim1, Hyoung Joon Chun1
1Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
Insights
Recurrence of chronic subdural hematoma (CSDH) after surgery is linked to factors like heterogeneous hematoma density. Identifying these predictors aids in better patient care for CSDH.
Area of Science:
- Neurosurgery
- Geriatric Medicine
- Radiology
Background:
- Chronic subdural hematoma (CSH) is prevalent in the elderly population.
- The increasing elderly demographic necessitates understanding CSH recurrence risk factors.
- Investigating factors influencing postoperative recurrence is crucial for managing CSH.
Purpose of the Study:
- To identify factors associated with the recurrence of chronic subdural hematoma (CSH) after surgical treatment.
- To analyze the relationship between preoperative imaging characteristics and CSH recurrence.
- To evaluate demographic and clinical factors contributing to CSH recurrence.
Main Methods:
- Retrospective analysis of 97 patients who underwent surgery for CSH.
- Initial treatment involved burr hole trephination and drainage for all patients.
- Evaluation of factors including hematoma internal architecture, hypertension, diabetes, drainage tube removal timing, and bilaterality.
Main Results:
- A recurrence rate of 16.5% (16/97) was observed within 3 months post-surgery.
- Heterogeneous hematoma density on preoperative CT scans showed a significant association with recurrence (p=0.002).
- Hypertension, diabetes mellitus, early drainage tube removal, and bilateral hematomas were also significantly related to recurrence.
Conclusions:
- The recurrence of CSH after burr hole drainage is influenced by multiple factors.
- Both demographic characteristics and preoperative CT findings, particularly heterogeneous hematoma type, are significant predictors of recurrence.
- Attention to these predictive factors is essential for improving the management and care of CSH patients.
Objective:
Chronic subdural hematoma (CSDH) is common in elderly patients. So, with an increasing number of elderly people in the general population, there is a need to investigate risk factors which increase recurrence rate. In this study, factors affecting the postoperative recurrence are investigated based on the reoperative CSDH cases.
Methods:
Total of ninety-seven patients was enrolled in this study who had have operation for CSDH. In all patients, one burr hole trephination and drainage was the method of choice for the initial treatment of CSDH. We retrospectively evaluated several factors which affect to recurrence of CSDH.
Results:
Retrospective analysis was performed in 97 patients. Sixteen patients experienced reoperation within 3 months (16/97, 16.5%) for recurrence of CSDH. And, when hematoma was divided by internal architecture, heterogeneous density group seems to be have close relationship with recurrence more significantly than homogeneous density group (p=0.002). Hypertension, diabetes mellitus, early removal of drainage tube, bilaterality of hematoma also have significant relationship with recurrence.
Conclusion:
Recurrence rate of CSDH treated with one burr hole drainage is related with some various factors. There was statistically significant difference between recurred group and non-recurred group. Not only demographic factors but also internal architecture on preoperative brain computed tomography is a significant predicting factor of recurrence in CSDH patients who underwent a surgery. In this study, heterogeneous type hematoma have significantly related with recurrence of CSDH. We should give attention to these predicting factors for more effective care.
