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

Sung Yong Ahn; Jong Hyun Kim; Sung Kohn Ha; Joo Han Kim; Taek Hyun Kwon; Youn Kwan Park; Hung Seob Chung

doi:10.13004/jknts.2011.7.2.68

Journal List > J Korean Neurotraumatol Soc > v.7(2) > 1084101

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Ahn, Kim, Ha, Kim, Kwon, Park, and Chung: Clinical Analysis of Risk Factors Associated with the Recurrence of Chronic Subdural Hematoma

Clinical Article

Journal of Korean Neurotraumatology Society 2011; 7(2): 68-73.

Published online: 31 October 2011

DOI: https://doi.org/10.13004/jknts.2011.7.2.68

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

Sung Yong Ahn, MD, Jong Hyun Kim, MD, Sung Kohn Ha, MD, Joo Han Kim, MD, Taek Hyun Kwon, MD, Youn Kwan Park, MD, Hung Seob Chung, MD

Department of Neurosurgery, Korea University College of Medicine, Guro Hospital, Seoul, Korea.

Address for correspondence: Jong Hyun Kim, MD. Department of Neurosurgery, Korea University College of Medicine, Guro Hospital, 97 Gurodong-gil, Guro-gu, Seoul 152-703, Korea. Tel: +82-2-2626-1178, Fax: +82-2-863-1684, jhkimns@gmail.com

Received 3 June 2011 Revised 16 August 2011 Accepted 16 August 2011

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.

Keywords: Chronic subdural hematoma, Recurrence, Duration of drainage

Figures and Tables

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.

TABLE 1

Characteristics and clinical findings of 260 patients with chronic subdural hematoma

RG: recurrence group, NRG: non-recurrence group

TABLE 2

Preoperative computed tomographic findings in 260 patients with chronic subdural hematoma

^*relationship between low/iso-density group and high/mixed-density group. RG: recurrence group, NRG: non-recurrence group

TABLE 3

Postoperative subdural air and duration of drainage in 260 patients with chronic subdural hematoma

RG: recurrence group, NRG: non-recurrence group

Notes

The authors have no financial conflicts of interest.

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