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Related Experiment Video

Updated: Mar 13, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Chronic subdural hematoma: Differences between unilateral and bilateral occurrence.

Cheng-Ta Hsieh1, I-Chang Su2, Szu-Kai Hsu2

  • 1Division of Neurosurgery, Department of Surgery, Sijhih Cathay General Hospital, New Taipei 22174, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan; Department of Chemistry, Fu Jen Catholic University, New Taipei City 24205, Taiwan; Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City 24205, Taiwan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|October 16, 2016
PubMed
Summary

Bilateral chronic subdural hematoma (CSDH) patients are older, less likely to abuse alcohol, and present with more nausea/vomiting and less midline shift. Surgery is effective for both unilateral and bilateral CSDH.

Keywords:
BilateralChronic subdural hematomaOutcomeRecurrenceUnilateral

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Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Chronic subdural hematoma (CSDH) is a common neurological condition.
  • Bilateral CSDH is less frequent than unilateral CSDH, with poorly defined characteristics.

Purpose of the Study:

  • To investigate clinical and radiological differences between bilateral and unilateral CSDH.
  • To compare patient demographics, symptoms, radiological findings, and surgical outcomes.

Main Methods:

  • Retrospective study of 75 surgically-treated CSDH patients (January 2011 - December 2015).
  • Patients divided into unilateral and bilateral CSDH groups.
  • Analysis of clinical features, radiological findings, surgical outcomes, postoperative bleeding, and recurrence.

Main Results:

  • 30.7% of patients had bilateral CSDH.
  • Bilateral CSDH patients were older (mean 79 vs 68.8 years) and had lower alcohol abuse history (8.7% vs 32.7%).
  • Bilateral CSDH patients more frequently presented with nausea/vomiting and showed less midline shift on CT scans.

Conclusions:

  • Bilateral CSDH patients are older, have less alcohol abuse history, more nausea/vomiting, and less midline shift.
  • Burr-hole craniostomy with closed drainage is effective for treating both unilateral and bilateral CSDH.
  • Most patients achieve favorable outcomes regardless of CSDH laterality.