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KMID : 0359819930220111239
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Journal of Korean Neurosurgical Society
1993 Volume.22 No. 11 p.1239 ~ p.1249
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Surgical Management of Chronic Subdural Hematoma: The Outcome and Factors Relating to /the Brain Expansion
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Abstract
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Ninety-seven patients with chronic subdural hematoma were treated surgically between 1983 and 1992. The case records and radiological findings on computerized tomography (CT) scan were studied with regard to surgical outcome and postoperative
brain
expansion after burr hole craniostomy and closed system drainage. Male : Female ratio was 3.6:1 and the peak incidence was in the sixth decade of life. The patients were graded according to the scale used by Markwalder et al. and 56% were in
Grade
0 and
1.
The CT scan demonstrated the brain expansion and resolution of subdural space within 2 weeks in 53% pof patients. Risk factors causing poor postoperative brain expansion were poor intraoperative brain expansion, too young (below 20 years) or too
old
(more than 71 years) age, and underlying disease. Following surgery, most of the patients improved. Whereas at the time of admission only 7% were neurologically normal (Grade 0), 67% of the patients fell into this category during the
postoperative
phase
and 90% of the patients were postoperatively in Crade 0 and 1. Four patients died in the hospital, for a mortality rate of 4.1%. The most important factor influencing outcome was preoperative neurologic state.
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