| Clinical Analysis of Risk Factors Related to Recurrent Chronic Subdural Hematoma. |
| Byung Soo Ko, Jung Kil Lee, Bo Ra Seo, Sung Jun Moon, Jae Hyoo Kim, Soo Han Kim |
| Department of Neurosurgery, Chonnam National University, Hospital & Medical School, Gwangju, Korea. jkl@chonnam.ac.kr |
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| ABSTRACT |
OBJECTIVE
Burr hole drainage has been widely used to treat chronic subdural hematoma (CSDH). However, the incidence of recurrent CSDH varies from 3.7 to 30% after surgery. The authors attempted to elucidate the risk factors associated with the recurrence of CSDH in one burr hole drainage technique.
METHODS: A total of 255 consecutive cases who underwent one burr hole drainage for CSDH were included in this study.
Twenty-four patients (9.4%) underwent a repeated operation because of the recurrence of CSDH. We analyzed retrospectively the demographic, clinical and radiologic factors associated with the recurrence of CSDH.
RESULTS: In this study, two risk factors were found to be independently associated with the recurrence of CSDH. The incidence of CSDH recurrence in the high- and mixed-density groups was significantly higher than those in the low- and iso-density groups (p<0.001). Bleeding tendency such as in leukemia, liver disease and chronic renal failure was also significantly associated with recurrence of CSDH (p=0.037).
CONCLUSION: These results suggest that high- and mixed-density shown on computed tomographic scan was closely relates with a high incidence of recurrence. Therefore, the operation could be delayed in those cases unless severe symptoms or signs are present. Reoperation using the previous burr hole site is a preferred modality to treat the recurrent CSDH. |
| Key Words:
Chronic subdural hematoma (CSDH); Recurrence; Computed tomography |
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