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KMID : 1001920110500020103
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Journal of Korean Neurosurgical Society
2011 Volume.50 No. 2 p.103 ~ p.108
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Chronic Subdural Hematoma Treated by Small or Large Craniotomy with Membranectomy as the Initial Treatment
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Kim Jae-Hong
Kang Dong-Soo
Kim Jung-Hee
Kong Min-Ho
Song Kwan-Young
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Abstract
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Objective : There are few studies comparing small and large craniotomies for the initial treatment of chronic subdural hematoma (CSDH) which had non-liquefied hematoma, multilayer intrahematomal loculations, or organization/calcification on computed tomography and magnetic resonance imaging. These procedures were compared to determine which would produce superior postoperative results.
Methods : Between 2001 and 2009, 317 consecutive patients were surgically treated for CSDH at our institution. Of these, 16 patients underwent a small craniotomy with partial membranectomy and 42 patients underwent a large craniotomy with extended membranectomy as the initial treatment. A retrospective review was performed to compare the postoperative outcomes of these two techniques, focusing on improvement of neurological status, complications, reoperation rate, and days of post-operative hospitalization.
Results : The mean ages were 69.4±12.1 and 55.6±9.3 years in the small and large craniotomy groups, respectively. The recurrence of hematomas requiring reoperation occurred in 50% and 10% of the small and large craniotomy patients, respectively (p<0.001). There were no significant differences in postoperative neurological status, complications, or days of hospital stay between these two groups.
Conclusion : Among the cases of CSDH initially requiring craniotomy, the large craniotomy with extended membranectomy technique reduced the reoperation rate, compared to that of the small craniotomy with partial membranectomy technique.
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KEYWORD
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Chronic subdural hematoma, Small craniotomy, Large craniotomy, Reoperation
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