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KMID : 1150320230190020050
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Journal of Korean Society of Geriatric Neurosurgery
2023 Volume.19 No. 2 p.50 ~ p.55
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Duration of brain expansion following minimally invasive drainage for chronic subdural hematoma: factors and implications
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Noh Chan-Yang
Park Ik-Seong
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Abstract
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Objective : This study investigated the temporal dynamics of brain expansion following minimally invasive drainage for chronic subdural hematoma (CSDH) and explored potential influencing factors.
Methods : We retrospectively analyzed 101 patients diagnosed with symptomatic CSDH who underwent surgical treatment. The procedure involved twist drill trephination without irrigation, performed by a single surgeon, followed by catheter drainage. We measured subdural fluid volume before and after surgery, with catheter removal occurring 24 to 48 hours post-surgery. Monthly brain computed tomography scans were conducted for up to 3 months to monitor brain expansion. Outpatient follow-up was concluded after the volume increase plateaued. We examined the duration until follow-up termination, changes in subdural collection volume, and relevant medical records.
Results : On average, treatment termination occurred 148±43 days post-surgery. Notably, patient age positively correlated with treatment duration (Pearson coefficient=0.728, P=0.001). However, preoperative subdural hematoma volume, comorbid conditions (e.g., diabetes and hypertension), and initial drainage volume on the first post-surgery day did not exhibit significant correlations with treatment duration.
Conclusion : This study indicates that brain expansion following surgery for CSDH occurs, on average, at 148 days, and a positive correlation was identified between brain expansion and patients’ age. Given this finding, it is crucial to carefully schedule follow-ups for CSDH patients to safely determine or initiate interventions in cases of recurrence as necessary.
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KEYWORD
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Chronic subdural hematoma, Trephining, Duration of treatment
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