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

J Korean Neurotraumatol Soc. 2011 Oct;7(2):68-73. Korean.
Published online October 31, 2011.  https://doi.org/10.13004/jknts.2011.7.2.68
Copyright © 2011 Korean Neurotraumatology Society
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 and 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, Email: jhkimns@gmail.com
Received June 03, 2011; Revised August 16, 2011; Accepted August 16, 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


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.
Click for larger image

Tables


TABLE 1
Characteristics and clinical findings of 260 patients with chronic subdural hematoma
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TABLE 2
Preoperative computed tomographic findings in 260 patients with chronic subdural hematoma
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TABLE 3
Postoperative subdural air and duration of drainage in 260 patients with chronic subdural hematoma
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Notes

The authors have no financial conflicts of interest.

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