J Korean Neurotraumatol Soc.  2011 Oct;7(2):68-73. 10.13004/jknts.2011.7.2.68.

Clinical Analysis of Risk Factors Associated with the Recurrence of Chronic Subdural Hematoma

• Ahn SY
• Kim JH
• Ha SK
• Kim JH
• Kwon TH
• Park YK
• Chung HS

• KMID: 2019916
• DOI: http://doi.org/10.13004/jknts.2011.7.2.68

Abstract

OBJECTIVE
Chronic subdural hematoma (CSDH) is one of the most common types of intracranial hemorrhage, especially in the elderly. Burr hole drainage has been widely used to treat CSDH. However, the incidence of recurrent CSDH varies from 3.7 to 30% after surgery. The purpose of this study was to demonstrate the risk factors associated with the recurrence of CSDH in burr hole drainage technique.
METHODS
A total of 260 consecutive cases who underwent burr hole drainage for CSDH were included in this study. Thirty patients (11.5%) underwent a repeated operation because of the recurrence of CSDH. We analyzed retrospectively the demographic, clinical, radiologic factors and surgical treatments associated with the recurrence of CSDH.
RESULTS
In our study, two risk factors were found to be independently related to the recurrence of CSDH. The incidence of CSDH recurrence in the high- or mixed-density groups was significantly higher than those in the low- or iso-density groups (p<0.001). The duration of drainage was also significantly related to the recurrence rate (p=0.007). Prolonged duration of drainage did not increase the frequency of infection in our series.
CONCLUSION
These results suggest that high- and mixed-density shown on computed tomographic (CT) scan was closely related with a high incidence of recurrence. Therefore, the operation could be delayed in those cases unless severe symptoms or signs are present. Also, we found in this study that the duration of drainage play an important role in the treatment of CSDH and 3 full days of drainage seems to be necessary.

Keyword

Chronic subdural hematoma; Recurrence; Duration of drainage

MeSH Terms

Aged
Drainage
Hematoma, Subdural, Chronic
Humans
Incidence
Intracranial Hemorrhages
Recurrence
Retrospective Studies
Risk Factors

Figure

• 

  FIGURE 1 Chronic subdural hematoma is classified according to its density on brain CT scans. A: High-type. B: Iso-type. C: Low-type. D: Mixed-type.

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