Clinical and Radiological Characteristics for Recurrence of Chronic Subdural Hematoma: A Systematic Review and...

Area of Science:

• Neurosurgery
• Radiology
• Epidemiology

Background:

• Chronic subdural hematoma (cSDH) is a significant neurosurgical condition.
• Recurrence presents a management challenge, with limited evidence on predictive factors.
• Understanding recurrence predictors is crucial for optimizing patient outcomes.

Purpose of the Study:

• To systematically review and meta-analyze clinical and radiological factors predicting cSDH recurrence.
• To identify statistically significant predictors based on PRISMA guidelines.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Comprehensive search of online databases.
• Inclusion of 14 studies, with 8 assessed as high methodological quality.

Main Results:

• Clinical risk factors for recurrence include advanced age (>75 years), anticoagulant use, obesity, seizures, and liver disease.
• Radiological predictors of recurrence involve the hematoma's internal structure, width, pneumocephalus, and bilaterality.
• Specific findings like internal architecture, hematoma width, and bilateral cSDH are significant radiological indicators.

Conclusions:

• Several clinical and radiological factors significantly predict chronic subdural hematoma recurrence.
• Identification of these factors can aid in risk stratification and management strategies.
• Further research can refine predictive models for cSDH recurrence.