Quantitative assessment of post-operative recurrence of chronic subdural haematoma using mean haematoma density

Lin, Chai-Ching; Lu, Yu-Mei; Chen, Tzu-Hsuan; Wang, Shin-Ping; Hsiao, Sheng-Huang; Lin, Muh-Shi

doi:10.3109/02699052.2014.901559

Cited by 23 publications

(22 citation statements)

References 19 publications

(33 reference statements)

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“…Although there were bilateral hematomas in 26% of our patients (37/140), no higher risk of recurrence was noted, whereas some other authors have described a correlation with a high recurrence rate [15,30].…”

Section: Recurrencecontrasting

confidence: 56%

See 1 more Smart Citation

Predictors of functional outcomes and recurrence of chronic subdural hematomas

Leroy¹,

Aboukaïs²,

Reyns³

et al. 2015

Journal of Clinical Neuroscience

106

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Section: Recurrencecontrasting

confidence: 56%

“…Nagakushi et al reported a correlation between the type of hematoma and cranial base location with a higher risk of recurrence. A higher density on CT scans was also reported as a risk factor for recurrence [14,15,28]. Higher density CSH have been reported to have a greater risk of rebleeding, and high protein exudation rates.…”

Section: Recurrencementioning

confidence: 95%

Predictors of functional outcomes and recurrence of chronic subdural hematomas

Leroy¹,

Aboukaïs²,

Reyns³

et al. 2015

Journal of Clinical Neuroscience

106

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“…Many studies suggest that preoperative hematoma density is associated with CSDH recurrence, and hyperdense hematoma is an independent risk factor for CSDH recurrence [13,38]. In present study, although nearly 1/3 of the patients had hyperdense imaging findings, according to our clinical experience and our definition of CSDH, neurosurgeons evaluated patients with subdural hematoma no matter what the density of subdural hematoma on imaging, once they were able to be treated with BHD, these patients could be managed as patients with CSDH.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, hematoma density was not significantly associated with postoperative AIH. We suspect that when hyperdense hematoma are compared with the other three types of hematoma density, repeated microhemorrhages from the immature capillary network in the outer membrane take place and accumulate over time, causing CSDH recurrence [38].…”

Section: Discussionmentioning

confidence: 99%

Predictors of acute intracranial hemorrhage and recurrence of chronic subdural hematoma following burr hole drainage

Chen

Wang

et al. 2020

BMC Neurol

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Background: To investigate predictors of postoperative acute intracranial hemorrhage (AIH) and recurrence of chronic subdural hematoma (CSDH) after burr hole drainage. Methods: A multicenter retrospective study of patients who underwent burr hole drainage for CSDH between January 2013 and March 2019. Results: A total of 448 CSDH patients were enrolled in the study. CSDH recurrence occurred in 60 patients, with a recurrence rate of 13.4%. The mean time interval between initial burr hole drainage and recurrence was 40.8 ± 28.3 days. Postoperative AIH developed in 23 patients, with an incidence of 5.1%. The mean time interval between initial burr hole drainage and postoperative AIH was 4.7 ± 2.9 days. Bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independent predictors of recurrence in the multiple logistic regression analyses. Preoperative headache was an independent risk factor of postoperative AIH in the multiple logistic regression analyses, however, intraoperative irrigation reduced the incidence of postoperative AIH. Conclusions: This study found that bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independently associated with CSDH recurrence. Clinical presentation of headache was the strongest predictor of postoperative AIH, and intraoperative irrigation decreased the incidence of postoperative AIH.

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“…Tugcu et al 22 found that bilateral hematoma was correlated with a high recurrence rate. Lin et al 23 discovered that the mean hematoma density, the separated type, and bilateral and skull base involvement of CSDHs were significantly related to postoperative recurrence. Protective factors have also been explored in many studies, including artificial cerebrospinal fluid irrigation 19,24 and postoperative drainage.…”

Section: Discussionmentioning

confidence: 99%

A New Modified Twist Drill Craniostomy Using a Novel Device to Evacuate Chronic Subdural Hematoma

2016

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Compared with burr hole craniostomy (BHC), twist drill craniostomy (TDC) is increasingly popular because of its minimal invasiveness in evacuating chronic subdural hematoma (CSDH). However, the TDC technique varies and is continually developing; moreover, no consensus yet exists regarding the optimal protocol, and the efficacy and safety of TDC is still controversial, especially with respect to a specific method. This article introduces a new modified TDC technique using a novel device, the YL-1 puncture needle, and evaluates its efficacy and advantages compared with BHC.A retrospective study involving 121 patients with CSDH who underwent surgery at a single center was conducted, involving 68 patients undergoing modified TDC (TDC group) and 53 patients treated by BHC (BHC group). The neurological outcome was studied to evaluate the surgery efficacy, and the radiological outcome was assessed as a supplement to the surgery efficacy. In addition, complications, recurrence, and reoperation, as well as pneumocrania, operation duration, and length of stay, were studied to evaluate the advantages of the modified TDC compared with BHC. Independent sample t tests or rank-sum tests were used to compare the outcomes between the 2 groups.The neurological and radiological outcomes did not differ significantly between the TDC and BHC groups (P = 0.852 and P = 0.232, respectively), while the rates of complication and pneumocrania in patients who underwent the modified TDC were significantly lower than that in those who underwent BHC (P = 0.021 and P < 0.001, respectively). The recurrence and reoperation rates in patients from the 2 groups were similar (P = 0.566 and P = 0.715, respectively). The operation duration and length of hospital stay of the patients who underwent the modified TDC were significantly shorter than those of the patients who underwent BHC (both P < 0.001).Modified TDC with a YL-1 puncture needle is a minimally invasive surgical technique to treat CSDH; this procedure is as effective as BHC, but safer and simpler than BHC, and should be considered for patients with CSDH, especially the elderly.

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Quantitative assessment of post-operative recurrence of chronic subdural haematoma using mean haematoma density

Abstract: This study provides statistical proof that MHD is a significant, independent, prognostic factor for the post-operative recurrence of CSDH. As such, consideration of MHD could aid in the prediction of post-operative prognosis of CSDHs.

Cited by 23 publications

References 19 publications

Predictors of functional outcomes and recurrence of chronic subdural hematomas

Predictors of functional outcomes and recurrence of chronic subdural hematomas

Predictors of acute intracranial hemorrhage and recurrence of chronic subdural hematoma following burr hole drainage

A New Modified Twist Drill Craniostomy Using a Novel Device to Evacuate Chronic Subdural Hematoma

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