Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 23:13:1012255.
doi: 10.3389/fneur.2022.1012255. eCollection 2022.

Recurrence of chronic subdural hematoma due to low-grade infection

Daniel Dubinski  1 , Sae-Yeon Won  1 , Svorad Trnovec  1 , Kseniya Gounko  1 , Peter Baumgarten  2 , Philipp Warnke  3 , Daniel Cantré  4 , Bedjan Behmanesh  1 , Joshua D Bernstock  5 , Thomas M Freiman  1 , Florian Gessler  1 , Steffen Sola  1
Affiliations

Recurrence of chronic subdural hematoma due to low-grade infection

Daniel Dubinski et al. Front Neurol. .

Abstract

Despite the high incidence and multitudes of operative techniques, the risk factors for chronic subdural hematoma (CSDH) recurrence are still under debate and a universal consensus on the pathophysiology is lacking. We hypothesized that clinically inapparent, a low-grade infection could be responsible for CSDH recurrence. This investigation is a single-center prospective observational study including patients with recurrent CSDH. In total, 44 patients with CSDH recurrence received an intraoperative swab-based microbiological test. The intraoperative swab revealed an inapparent low-grade hematoma infection in 29% of the recurrent CSDH cases. The majority (69%) of the identified germs belonged to the staphylococcus genus. We therefore, propose a novel potential pathophysiology for CSDH recurrence.

Keywords: MMA occlusion; chronic subdural hematoma; dexamethasone; infected subdural hematoma recurrence; recurrence.

PubMed Disclaimer

Conflict of interest statement

Author DD received financial support from Novartis, Fresenius, Inovitro, and Novocure. None of these entities were involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study allocation with the illustration of the study protocol.
Figure 2
Figure 2
Pie chart composition of the positive microbiological swab results in recurrent CSDH.
See this image and copyright information in PMC

References

    1. Yang W, Huang J. Chronic subdural hematoma: epidemiology and natural history. Neurosurg Clin N Am. (2017) 28:205–10. 10.1016/j.nec.2016.11.002 - DOI - PubMed
    1. Fang H, Zhang Z, Liu Y, Wang L, Yang Y, Li S, et al. . Rigid neuroendoscopy assisted hematoma resection reduces the recurrence rate of chronic subdural hematoma with mixed density: a retrospective analytic cohort study. Front Surg. (2022) 9:167. 10.3389/fsurg.2022.789118 - DOI - PMC - PubMed
    1. Sahyouni R, Goshtasbi K, Mahmoodi A, Tran DK, Chen JW. Chronic subdural hematoma: a historical and clinical perspective. World Neurosurg. (2017) 108:948–53. 10.1016/j.wneu.2017.09.064 - DOI - PubMed
    1. Kayaci S, Kanat A, Koksal V, Ozdemir B. Effect of inner membrane tearing in the treatment of adult chronic subdural hematoma: a comparative study. Neurol Med Chir (Tokyo). (2014) 54:363–73. 10.2176/nmc.oa.2013-0147 - DOI - PMC - PubMed
    1. Won S-Y, Dubinski D, Brawanski N, Strzelczyk A, Seifert V, Freiman TM, et al. . Significant increase in acute subdural hematoma in octo- and nonagenarians: Surgical treatment, functional outcome, and predictors in this patient cohort. Neurosurg Focus. (2017) 43. 10.3171/2017.7.FOCUS17417 - DOI - PubMed

LinkOut - more resources