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Risk Factor Analysis for the Recurrence of Chronic Subdural Hematoma: A Review of 368 Consecutive Surgical Cases
Junhak Kim1, Jongun Moon1, Tackeun Kim1
1Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Insights
Male sex, malignant neoplasm history, and specific hematoma types increase the risk of chronic subdural hematoma (CSDH) recurrence after burr hole surgery. Identifying these factors aids in predicting patient outcomes.
Area of Science:
- Neurosurgery
- Radiology
- Geriatrics
Background:
- Chronic subdural hematoma (CSDH) is a prevalent neurological condition in elderly individuals.
- Surgical intervention, typically burr hole trephination, is the standard treatment for CSDH.
- CSDH recurrence rates vary significantly, ranging from 2.3% to 33%.
Purpose of the Study:
- To identify clinical and radiological risk factors associated with CSDH recurrence following burr hole trephination.
- To enhance the understanding of factors contributing to treatment failure in CSDH patients.
Main Methods:
- Retrospective review of 368 consecutive patients treated for CSDH via burr hole trephination.
- Univariate and multivariate analyses were employed to assess the relationship between various factors and recurrence.
- Clinical data and radiological findings from computed tomography (CT) scans were analyzed.
Main Results:
- A total of 31 patients (8.4%) experienced CSDH recurrence.
- Higher recurrence rates were observed in males (10.2%) compared to females (3.1%).
- Patients with a history of malignant neoplasm (17.9%), single-layer CSDH (13.1%), and isodense CSDH (11.7%) showed significantly higher recurrence rates.
Conclusions:
- Male sex, a history of malignant neoplasm, and specific CT-identified hematoma types (single-layer and isodense) are significant risk factors for CSDH recurrence.
- These identified factors can assist clinicians in predicting which patients are at higher risk for CSDH recurrence.
- Further research may focus on tailored management strategies for high-risk patient groups.
Objective:
Chronic subdural hematoma (CSDH) is a common form of extra axial hemorrhage in the elderly. A surgical procedures such as a burr hole trephination are used for the CSDH treatment. The recurrence rate of CSDH is reported to range from 2.3 to 33%. In the current study, we focused on the determination of risk factors associated with the recurrence of CSDH.
Methods:
We retrospectively reviewed 368 consecutive patients with CSDH treated by burr hole trephination. Univariate and multivariate analysis were performed to describe the relationships between clinical and radiological factors as well as the recurrence of CSDH.
Results:
Totally 31 (8.4%) patients experienced a recurrence of CSDH in our study. The male group (10.2%) had a higher recurrence rate than the female group (3.1%). Also patients with malignant neoplasm history showed a high recurrence rate (17.9%). The recurrence rate of single layer CSDH (13.1%) and isodensity CSDH (11.7%) was highly significant also.
Conclusion:
Sex, history of malignant neoplasm and the hematoma type on computed tomography were factors related with the recurrence of CSDH in our study. These findings may be supportive in the identification of patients at risk for a recurrence of CSDH.
