Radiolological predictors of recurrence of chronic subdural hematoma

Objective: Chronic subdural hematoma is one of the most common clinical entities encountered in daily neurosurgical practice. Considerable recurrence rates have been reported for chronic subdural hematoma following surgical evacuation. Many studies have suggested various radiological factors that may be associated with the recurrence of CSDH. However, the results are inconsistent. This study focuses on determining the radiological factors predictive of chronic subdural hematoma recurrence

Methods: A retrospective analysis of 113 patients diagnosed with chronic subdural hematoma who were surgically treated between August 2013 and December 2014 was performed. The radiological features were analyzed to clarify the correlation between these radiological factors and postoperative recurrence of chronic subdural hematoma

Results: Twenty patients [17.7%] experienced recurrence. Chronic subdural hematoma recurrence was found to be significantly associated [p<0.05] with preoperative hematoma thickness >/= 20 mm. Midline shift, hematoma density and bilaterality were not significantly associated with recurrence. Post operative drainage also significantly [p<0.05] reduced chronic subdural hematoma recurrence

Conclusion: Preoperative hematoma thickness >/= 20 mm is an independent predictor of recurrence of chronic subdural hematoma. Postoperative drainage also significantly reduces chronic subdural hematoma recurrence

Primary intracranial brain tumours; a clinico-pathological study

Seventy-eight patients of different brain Tumours were studied from April 1998 to June 1999. Age, sex, presenting complaints, and location of tumour were analyzed. After presurgical evaluation these patients were operated and specimens were sent for histopathological examination. Majority of patients presented with signs and symptoms of raised intracranial pressure. Focal cerebral syndromes attributable to frontal, temporal, parietal and occipital lobe were also seen. Incompletely resected grade II astrocytomas received post-operative radiotherapy only. Whereas high grade astrocytomas whether completely or incompletely resected were given post-operative radiotherapy and chemotherapy. Histopathological analysis revealed that majority of the patients had astrocytomas others included pituitary adenoma, craniopharyngioma, meningioma, medulloblastoma and schwannoma. Some degree of necrosis was present in both anaplastic astrocytoma and glioblastoma multiform patients [46.43%]. But extensive necrosis was seen only in patients with glioblastoma multiform. Infiltrative component was seen in the majority of astrocytoma patients [90.48%]