ANALYSIS OF THE PREDICTIVE FACTORS IN ACUTE SUBDURAL HEMATOMA LEADING TO PROGRESSION IN HEMATOMA IN THE SUBACUTE PHASE

Abstract

　　Background : Conservative treatment exists for acute subdural hematoma. However, in some cases, hematoma increases in the subacute phase. Here, we report the analysis of predictive factors related to acute subdural hematoma that lead to hematoma increase in the subacute phase. Methods : We included patients with acute subdural hematoma who were hospitalized from 2003 through 2014 in the department of neurosurgery at our hospital. We excluded patients who had undergone an operation in the acute phase, had non-aggressive treatment, or had a cerebral contusion or acute epidural hematoma. We included 261 cases of acute subdural hematoma in the convexity. We compared cases in which hematoma increased in the subacute phase with those in which hematoma did not increase. Result : Forty-three cases demonstrated an increase in hematoma in the subacute phase. In 218 cases, hematoma did not increase. The following factors were predictive factors of increase of hematoma in the subacute phase : age, prevalence of diabetes mellitus, hematoma thickness, and midline shift. Conclusion : In elderly patients who were able to receive conservative treatment until the subacute phase, hematoma increased in the subacute phase.