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Risk Factors for Recurrence of Chronic Subdural Hematoma: A Single Center Experience

Lun-Xin Liu1, Xu-Dong Cao2, Yan-Ming Ren1

  • 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

World Neurosurgery
|August 27, 2019
PubMed

Insights

Mixed density hematoma is a key predictor for chronic subdural hematoma (CSDH) recurrence after surgery. Identifying this on CT scans can help anticipate and manage CSDH recurrence risks.

Area of Science:

  • Neurosurgery
  • Radiology
  • Clinical Medicine

Background:

  • Chronic subdural hematoma (CSDH) presents a significant challenge due to its high postsurgical recurrence rates.
  • Effective identification of predictive factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate predictive factors for postsurgical recurrence of chronic subdural hematoma (CSDH).
  • To identify specific patient and hematoma characteristics associated with CSDH recurrence.

Main Methods:

  • Retrospective review of 328 CSDH patients treated between January 2012 and June 2018.
  • Univariate and multivariate analyses were conducted to assess relationships between recurrence and factors including age, sex, injury history, CT findings, and surgical methods.
  • Computed tomography (CT) findings were categorized by hematoma density (mixed, isodensity, high, low).

Main Results:

  • The overall recurrence rate was 2.44% (8 of 328 patients).
  • Mixed density hematoma was identified as an independent risk factor for CSDH recurrence.
  • Recurrent hematomas were predominantly mixed density (7 of 8), with one isodensity case.

Conclusions:

  • Burr hole craniostomy with irrigation and closed-system drainage is an effective surgical treatment for CSDH.
  • Mixed density hematoma on CT is a significant independent predictor of CSDH recurrence.
  • A thick inner neomembrane may be a primary cause of CSDH recurrence.
Abstract

Keywords:
Burr holeChronic subdural hematomaMembraneMixed density hematomaRecurrence

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