J Korean Neurosurg Soc.  2008 Jan;43(1):11-15. 10.3340/jkns.2008.43.1.11.

Clinical Analysis of Risk Factors Related to Recurrent Chronic Subdural Hematoma

Affiliations
  • 1Department of Neurosurgery, Chonnam National University, Hospital & Medical School, Gwangju, Korea. jkl@chonnam.ac.kr

Abstract


OBJECTIVE
Burr hole drainage has been widely used to treat chronic subdural hematoma (CSDH). However, the incidence of recurrent CSDH varies from 3.7 to 30% after surgery. The authors attempted to elucidate the risk factors associated with the recurrence of CSDH in one burr hole drainage technique.
METHODS
A total of 255 consecutive cases who underwent one burr hole drainage for CSDH were included in this study. Twenty-four patients (9.4%) underwent a repeated operation because of the recurrence of CSDH. We analyzed retrospectively the demographic, clinical and radiologic factors associated with the recurrence of CSDH.
RESULTS
In this study, two risk factors were found to be independently associated with the recurrence of CSDH. The incidence of CSDH recurrence in the high- and mixed-density groups was significantly higher than those in the low- and iso-density groups (p<0.001). Bleeding tendency such as in leukemia, liver disease and chronic renal failure was also significantly associated with recurrence of CSDH (p=0.037).
CONCLUSION
These results suggest that high- and mixed-density shown on computed tomographic scan was closely relates with a high incidence of recurrence. Therefore, the operation could be delayed in those cases unless severe symptoms or signs are present. Reoperation using the previous burr hole site is a preferred modality to treat the recurrent CSDH.

Keyword

Chronic subdural hematoma (CSDH); Recurrence; Computed tomography

MeSH Terms

Drainage
Hematoma, Subdural, Chronic
Hemorrhage
Humans
Incidence
Kidney Failure, Chronic
Leukemia
Liver Diseases
Recurrence
Reoperation
Retrospective Studies
Risk Factors
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