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KMID : 1001920040350040410
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Journal of Korean Neurosurgical Society
2004 Volume.35 No. 4 p.410 ~ p.414
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Postoperative Radiological Changes in Chronic Subdural Hematoma and Its Relation to Recurrence
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Kwon Hyon-Jo
Youm Jin-Young
Kim Seon-Hwan
Koh Hyeon-Song
Song Shi-Hun
Kim Youn
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Abstract
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Objective : The authors .)nalried the postoperative radiological changes in chronic subdural hematoma(CSDH) after operation and its relation to the recurrence.
Methods : After reviewing the postoperative imagings of CSDH patients(90 cases, 70 patients), we classified them into 4 types according to the radiological changes in the hematoma area and calculated the prevalence of recurrence respectively. Wry ;,ku reviewed the preoperative images of the same patients and classified them into 4 types according to hematora density and internal structure and investigated the prevalence of recurrence after operation respectively.
Results : The low density area in postoperative computerized tomography(C) showed the same Hounsfield unit and signal intensity in magnr!tic resonance imaging(MRI) with the CSF in ventricles. The recurrence of CSDH was lower if the hematoma was totally replaced with CSF (Type III) or the brain re-expanded completely with total hematoma drainage (Type IVY on postoperative imagings(p<0.05). The location of catheter tip can be used as a valuable indicator of the boundary of newly collected CSF and residual hematoma.
Conclusion : The low-density area found on postoperative Cr medial to the residual hematoma in CSDH is filled with CSF and it can be a helpful factor in reducing the recurrence. The catheter tip location can be used as a good index and we can remove the catheter immediately after confirming the tip location on the inner surface of the skull.
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KEYWORD
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Chronic subdural hematoma, Catheter tip, Recurrence, Density
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