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KMID : 1001920080430010011
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Journal of Korean Neurosurgical Society
2008 Volume.43 No. 1 p.11 ~ p.15
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Clinical Analysis of Risk Factors Related to Byung-Soo Ko, M.D. Recurrent Chronic Subdural Hematoma
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Lee Jung-Kil
Seo Bo-Ra
Moon Sung-Jun
Kim Jae-Hyoo
Kim Soo-Han
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Abstract
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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.
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KEYWORD
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Chronic subdural hematoma (CSDH), Recurrence, Computed tomography
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