Factors Influencing Recurrent Chronic Subdural Hematoma after Surgery

ABSTRACT

OBJECTIVE: The authors attempted to confirm the risk factors for recurrent chronic subdural hematoma(CSDH) after simple burr-hole drainage. METHODS: A total of 302 patients with CSDH who were treated at our hospital between January 1998 and May 2005 were studied. Various parameters considered for analysis of factors associated with CSDH recurrence; demographic and clinical findings (age, sex, history of seizures, diabetes, vascular diseases), initial and perioperative CT findings (hematoma density, location of catheter tip, post operative intracranial air, intracranial hematoma extension, hematoma width, hematoma site). RESULTS: Twenty-four patients (7.9%) experienced recurrence, whereas 278 patients (92.1%) did not. Five major risk factors should be considered 1) layered type by hematoma density, 2) type I, II by location of catheter tip, 3) presence of postoperative intracranial air, 4) cranial base type of intracranial hematoma extension, 5) greater hematoma width. CONCLUSION: In this study, we report that the incidence of postoperative CSDH recurrence can be reduced by the examination of the hematoma chracteristics on initial and perioperative CT findings and by preventing subdural air accumulation during operation. In addition, the location of the catheter tip can be used as a helpful factor in reducing the recurrence.