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Analysis of predisposing factors for chronic subdural hematoma recurrence
Rafael Gomes Dos Santos1, Paulo Adolfo Wessel Xander1, Leonardo Henrique da Silva Rodrigues1
1Resident Physician of the Neurosurgery Course at the Irmandade da Santa Casa de Misericórdia of São Paulo, São Paulo, SP, Brasil.
Insights
Older age is a protective factor against Chronic Subdural Hematoma (CSDH) recurrence after surgery. This study found age significantly reduces the risk of CSDH returning, suggesting simpler surgical approaches may be preferred.
Area of Science:
- Neurosurgery
- Neurology
- Public Health
Background:
- Chronic Subdural Hematoma (CSH) is a common neurosurgical condition.
- Understanding recurrence factors is crucial for patient management and outcomes.
Purpose of the Study:
- To investigate recurrence rates of Chronic Subdural Hematoma (CSDH).
- To identify potential predisposing factors for CSDH recurrence following surgical treatment.
Main Methods:
- Retrospective analysis of 500 patient medical records diagnosed with CSDH.
- Surgical treatment data from 2000 to 2014 at a São Paulo reference hospital were reviewed.
Main Results:
- A recurrence rate of 5.4% (27 out of 500 patients) was observed.
- No significant differences in recurrence were found based on gender, laterality, or initial surgical procedure (trepanning vs. craniotomy).
- Increasing age was identified as a statistically significant protective factor against CSDH recurrence.
Conclusions:
- Age is a significant protective factor for Chronic Subdural Hematoma recurrence.
- The lack of difference between trepanning and craniotomy supports burr-hole surgery as a preferred, less complex option.
Objectives:
To identify recurrence and its potential predisposing factors in a series of 595 patients with an initial diagnosis of Chronic Subdural Hematoma (CSDH) who underwent surgical treatment at a Reference Hospital of São Paulo.
Methods:
A retrospective descriptive study, in which the medical records of all patients with a CSDH diagnosis submitted to surgical treatment from 2000 to 2014 were analyzed.
Results:
The final study population consisted of 500 patients with a diagnosis of CSDH (95 patients with a diagnosis of Cystic Hygroma were excluded), of which 27 patients presented recurrence of the disease (5.4%). There were no statistically significant differences in relapses when cases were stratified by gender, laterality of the first episode or surgical procedure performed in the first episode (trepanning vs. craniotomy). It was possible to demonstrate an age-related protective factor, analyzed as a continuous variable, regarding the recurrence of the CSDH, with a lower rate of recurrence the higher the age.
Conclusions:
The results indicate that, among possible factors associated with recurrence, only age presented a protective factor with statistical significance. The fact that no significant difference between the patients submitted to trepanning or craniotomy was found favors the preferential use of burr-hole surgery as a procedure of choice due to its fast and less complex execution.
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