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. 2008 Jan;43(1):11-5.
doi: 10.3340/jkns.2008.43.1.11. Epub 2008 Jan 20.

Clinical analysis of risk factors related to recurrent chronic subdural hematoma

Byung-Soo Ko  1 , Jung-Kil Lee, Bo-Ra Seo, Sung-Jun Moon, Jae-Hyoo Kim, Soo-Han Kim
Affiliations

Clinical analysis of risk factors related to recurrent chronic subdural hematoma

Byung-Soo Ko et al. J Korean Neurosurg Soc. 2008 Jan.

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.

Keywords: Chronic subdural hematoma (CSDH); Computed tomography; Recurrence.

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Figures

Fig. 1
Fig. 1
Chronic subdural hematoma is classified according to its density on brain CT scans. A: High-type, B: Iso-type, C: Low-type, D: Mixed-type.
See this image and copyright information in PMC

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