Third Ventricle Volume Predicts Functional Outcome in Chronic Subdural Hematoma

Area of Science:

• Neurosurgery
• Radiology
• Medical Imaging

Background:

• Chronic subdural hematoma (CSDH) management lacks predictive tools for clinical outcomes.
• Computed tomography (CT) is crucial for CSDH diagnosis but its predictive utility for outcomes is understudied.

Purpose of the Study:

• To evaluate the role of tomographic volumetric analysis in predicting clinical outcomes for CSDH patients.
• To determine if preoperative CT measurements can forecast functional recovery after CSDH treatment.

Main Methods:

• Retrospective analysis of 79 CSDH patients undergoing burr-hole craniostomy (BHC).
• Preoperative CT scans were analyzed for midline shift, hematoma volume, and ventricle volumes (3VV, 4VV) using semiautomatic segmentation.
• Postoperative outcomes assessed by NIHSS at discharge and mRS at 6 weeks.

Main Results:

• Increased preoperative third ventricle volume (3VV) significantly correlated with poor NIHSS at discharge (p=.01) and 6-week mRS (p=.03).
• A 3VV threshold of 0.545 mL showed high sensitivity (77.1%) and specificity (88.8%) for predicting functional dependence.
• Elevated 3VV was a strong independent predictor of poor functional outcome (OR 9.29, p=.001).

Conclusions:

• Preoperative tomographic third ventricle volume (3VV) is an independent prognostic factor for CSDH patient outcomes.
• A 3VV threshold of 0.545 mL can identify patients at higher risk of dependency post-treatment, aiding clinical decision-making.