2016 Volume 25 Issue 9 Pages 748-753
Chronic subdural hematoma (CSDH) is one of the most common neurosurgical pathologies and it is often surgically treated by burr-hole drainage. However, the reported rate of post-surgical recurrence is around 10%, and some factors have been investigated. We describe recurrence risk factors for chronic subdural hematoma retrospectively determined from experience at our institution.
The clinical characteristics and CT findings were analyzed in a series of 187 patients who underwent burr-hole surgery at our hospital (222 surgeries) between January 1, 2014 and July 31, 2015.
Recurrence was identified in 26 (13.9%) of 187 patients and clinically significant risk factors were age, hypertension and anticoagulants. Other significant risk factors comprised preoperative CT findings of hematoma volume, midline shift and niveau, as well as post-operative CT findings of hematoma reduction rates between days 1 and 7. The rate of hematoma reduction decreased, indicating an increase in hematoma between post-operative days 1 and 7 in patients with recurrence. We consider that a post-operative increase in the size of a hematoma can predict recurrence in the early stages.
