Korean J Neurotrauma.  2014 Oct;10(2):55-59. 10.13004/kjnt.2014.10.2.55.

Chronic Subdural Hematomas: Comparison between Unilateral and Bilateral Involvement

• Park HS
• Park ES
• Park JB
• Kwon SC
• Lyo IU
• Kim MH
• Sim HB

• KMID: 2256231
• DOI: http://doi.org/10.13004/kjnt.2014.10.2.55

Abstract

OBJECTIVE
Chronic subdural hematoma (CSDH) is a common intracranial hemorrhage, encountered in neurosurgical practice. Most CSDHs are unilateral, but some show bilateral involvement. However, the clinical characteristics of bilateral CSDH remain unclear. In this study, we investigated the clinical differences between bilateral and unilateral CSDH.
METHODS
A retrospective study was performed on 120 patients with CSDH surgically treated at our institute from January 2008 to December 2012. Patients were divided into two groups: the bilateral CSDH and the unilateral CSDH groups. Clinical presentations, precipitating factors, computed tomography (CT) findings, postoperative complications, and outcomes of patients were analyzed.
RESULTS
Bilateral CSDH was identified in 11 of 120 (10.9%) patients with CSDH. Patients with bilateral CSDH tended to have a lower rate of head injury compared to patients with unilateral CSDH (36.4% vs. 59.6%), but it had no statistical significance (p=0.201). The frequency of marked midline shift on CT scans was significantly greater in unilateral CSDH than in bilateral CSDH (p=0.010). Presenting symptoms, coexisting systemic diseases, postoperative complications, and clinical outcomes were not significantly different between the two groups.
CONCLUSION
Bilateral CSDH has comparatively similar clinical features and precipitating factors as unilateral CSDH. Patients with bilateral CSDH have significantly lower incidences of midline shift on CT scans, and most patients with either bilateral or unilateral CSDH have good postoperative outcomes.

Keyword

Hematoma subdural chronic; Hematoma subdural intracranial; Treatment outcome; Prognosis

MeSH Terms

Craniocerebral Trauma
Hematoma, Subdural, Chronic*
Humans
Incidence
Intracranial Hemorrhages
Postoperative Complications
Precipitating Factors
Prognosis
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome

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