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KMID : 1143720110070020099
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Korean Journal of Neurotrauma
2011 Volume.7 No. 2 p.99 ~ p.102
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Postoperative Lesion Side Down Posture in Patients with Chronic Subdural Hematoma: Its Impact on Hospital Stay and Recurrence Rate
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Rho Young-Joon
Choe Woo-Jin
Chun Young-Il
Cho Joon
Moon Chang-Taek
Chang Sang-Keun
Koh Young-Cho
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Abstract
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Objective:Chronic subdural hematomas (CSDHs) are usually encountered in the elderly patients. There are a lot of studies covering surgical techniques but, studies regarding the prognosis depending on the patient’s postoperative posture are few. This study was carried out to elucidate the efficiency of the lesion side down posture over the ordinary supine posture.
Methods:The authors retrospectively analyzed the results of CSDHs in 78 patients without known risk factors of CSDHs recurrence. All patients underwent one burr-hole surgery with closed system drainage and were then allocated to Group A, who were kept in a lateral position with the operation site downward for 3-5 days after operation, and to Group B, who were kept in supine neutral position. Postoperative computed tomography scans were checked on postoperative day (POD) 1, POD 3, day of discharge, and on POD 90. The amount of CSDHs was assessed in each group on these postoperative CT scans.
Results:In Group A, there was significant earlier brain re-expansion and hematoma drainage (p=0.02) and shorter hospital stay (p=0.01). Six (7.69%) patients underwent reoperation, two (2.56%) in Groups A and four (5.13%) in Group B. There was no significant difference between the two groups in recurrence rate (p=0.91).
Conclusion:Maintaining lesion side down posture in the early postoperative period in CSDHs seems to be beneficial in shortening hospitalization by earlier brain expansion and hematoma drainage.
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KEYWORD
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Chronic subdural hematoma, Posture, Recurrence, Hospitalization
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