Independent Predictors for Recurrence of Chronic Subdural Hematoma

Jung, Yoon-Gyo; Jung, Na Young; Kim, El

doi:10.3340/jkns.2015.57.4.266

Cited by 149 publications

(28 citation statements)

References 27 publications

(38 reference statements)

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“…Similar rates were observed by Yamamoto et al and Lee et al [18][19]. Jung et al observed recurrence of cSDH in about 13% of patients included in their study [22] and Torihashi in about 17% [17]. In their review of 48 studies, Weigel et al established that cSDH recurrence rate varied between 10 and 33% [15].…”

Section: Discussionsupporting

confidence: 68%

“…Potential predictors of cSDH recurrence have been widely analyzed by other researchers and many factors were identified. The most common was age, bilateral cSDH, anticoagulants intake and approach related complications [18][19][20][21][22]. On the other hand most of authors analyze total recurrence rate regardless of the time period, neglecting early, acute reoperations of cSDH.…”

Section: Introductionmentioning

confidence: 99%

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Early reoperations in chronic subdural hematoma

Kwinta

Krzyżewski

Kliś

et al. 2018

Medical Research Journal

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Background: The recurrence rate of chronic subdural hematoma (cSDH) is high and early reoperation is often required. Aim: The aim of this study was to evaluate prognostic factors for early reoperation of chronic subdural hematomas (cSDH) treated by classical and minimally invasive approach. Materials and Methods: We retrospectively analyzed the medical history of 355 cSDH patients treated with formal craniotomy and minimally invasive burr hole craniostomy. We determined the potential predictors of early reoperations. Results: A total of 33 (9.3%) patients required early reoperation. Those patients more often underwent craniotomies instead of burr hole craniostomies (36.4% vs. 62.7%, p < 0.01) and took steroids before hospitalization (3.0% vs. 0.3%, p = 0.04) than non-reoperated patients. Patients who had surgery on the right side were less likely to be reoperated (51.9% vs. 33.3%, p = 0.04). On multivariate analysis the frontal (OR = 5.284, 95% CI: 1.293-21.76, p = 0.019) and large craniotomy (OR = 2.297, 95% CI: 1.004-5.258, p = 0.048) remained independent risk factors for early reoperation of cSDH. Conclusions: Neurosurgeons should consider the evacuation of a cSDH with help of minimally invasive burr hole craniostomy in most of the cases, as well as avoid large and frontal and craniotomies in order to prevent early reoperation of cSDH.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Early reoperations in chronic subdural hematoma

Kwinta

Krzyżewski

Kliś

et al. 2018

Medical Research Journal

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“…The CSDH the cure rate after drainage by trepanation is high, but the neurological deterioration occasionally complicates the course of the postoperative period, requiring postoperative surveillance 24,25 . Acute subdural hematoma, intracranial hypertensive hemorrhage, hypertensive pneumoencephalus and other cerebrovascular diseases can occur as postoperative complications 2,[26][27][28] . In our series there were no cases of surgical postoperative complications, only clinical ones, such as infections and heart disease, in 9% of patients.…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…CSDH is a common disease in the neurosurgeon practice, but still associated with significant morbidity and mortality 27,28 . In our patients, the change of consciousness was the most frequent clinical alteration in elderly patients, and headache in the non-elderly.…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Chronic subdural hematoma: epidemiological and prognostic analysis of 176 cases

Neto¹,

Araújo²,

Ferraz³

et al. 2015

Rev. Col. Bras. Cir.

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Objective : To characterize patients with chronic subdural hematoma undergoing surgery and to identify prognostic indicators. Methods : We conducted a retrospective analysis of patients diagnosed with chronic subdural hematoma (CSDH) undergoing surgical treatment. We analyzed: age, period from trauma to diagnostic imaging, pre and postoperative Glasgow coma scale, type of surgery, associated comorbidities, use of postoperative drainage and outpatient treatment. Results : The sample consisted of 176 patients, 126 male and 50 female patients (ratio 2.5 : 1), ages ranged from six months to 97 years, with an average of 59.3 years. CSDH was caused by trauma in 52% of patients, with the time from trauma to imaging averaging 25.05 days; 37.7% were hypertensive patients and 20% had a neurological disease. Eighty-five (48.3%) patients were elderly and altered consciousness was present in 63% of cases. Of the 91 (51.7%) non-elderly patients, 44% presented with headache, altered consciousness occurred in 40% and motor abnormalities in 27.5%. The CSDH was located on the right in 41%, left in 43% and bilaterally in 16% of patients. Conclusion : the change of consciousness was the most common clinical alteration in the elderly and headache in non-elderly. The most associated comorbidity was the arterial hypertension and the most frequent cause, head trauma. The trepanation with two oriffices associated with a closed drainage system was the most used operating, with high efficacy and low complication rate.

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“…Insufficient re-expansion of the brain is considered the key reason for postoperative CSDH recurrence. 9 12) Other reasons are old age, a separated type of CSDH, intracranial hypotension, anticoagulant therapy, and inappropriate timing of operation. 1 5 8 16 20 23) Several measures have been assessed to prevent recurrence, including corticosteroids, angiotensin receptor antagonists, upright head positioning, and continuous postoperative subdural irrigation, 1 3 22) but evidence on the efficacy of these measures is limited.…”

Section: Discussionmentioning

confidence: 99%

Effects of Oral Streptokinase-Streptodornase on Remnant Chronic Subdural Hematomas

Park

Kim

2015

Korean J Neurotrauma

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ObjectiveIn most cases, the postoperative course of a chronic subdural hematoma (CSDH) is good, but CSDHs sometimes remain after the inserted catheter is removed, and the outcomes of such remnant hematomas are unclear. As oral streptokinase-streptodornase (OSS) has anti-inflammatory and hematologic effects, we assessed the effects of OSS on remnant CSDHs through a retrospective analysis of clinical data.MethodsThis study included 101 patients with traumatic CSDH who had remnant CSDH after burr-hole trephination with the closed drainage system between October 2009 and December 2012. We assessed the clinical outcomes, remnant CSDH volume, and recurrence rate from computed tomography scans in order to evaluate the effects of OSS.ResultsNo significant differences were found in the changes in remnant hematoma volume between the OSS-treated and non-treated groups (p=0.531). The reoperation rate because of was 5.4% (2 patients) in the OSS-treated group and 6.3% (4 patients) in the non-treated group. The number of patients requiring reoperation did not differ between the groups (p=0.658).ConclusionOSS treatment was not associated with a significant reduction in the remnant CSDH volume or recurrence rate after burr-hole drainage. Thus, there seems to be no basis for using OSS in CSDH patients.

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Independent Predictors for Recurrence of Chronic Subdural Hematoma

Cited by 149 publications

References 27 publications

Early reoperations in chronic subdural hematoma

Early reoperations in chronic subdural hematoma

Chronic subdural hematoma: epidemiological and prognostic analysis of 176 cases

Effects of Oral Streptokinase-Streptodornase on Remnant Chronic Subdural Hematomas

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