Radiological predictors of recurrence of chronic subdural hematoma

Abstract

Objective:Chronic subdural hematoma is one of the most common clinical entities encountered in daily neurosurgical practice. Considerable recurrence rates have been reported for chronic subdural hematoma following surgical evacuation. Many studies have suggested various radiological factors that may be associated with the recurrence of CSDH. However, the results are inconsistent. This study focuses on determining the radiological factors predictive of chronic subdural hematoma recurrence.Methods:A retrospective analysis of 113 patients diagnosed with chronic subdural hematoma who were surgically treated between August 2013 and December 2014 was performed. The radiological features were analyzed to clarify the correlation between these radiological factors and postoperative recurrence of chronic subdural hematoma.Results:Twenty patients (17.7%) experienced recurrence. Chronic subdural hematoma recurrence was found to be significantly associated (p<0.05) with preoperative hematoma thickness ≥ 20 mm. Midline shift, hematoma density and bilaterality were not significantly associated with recurrence. Post operative drainage also significantly (p<0.05) reduced chronic subdural hematoma recurrence.Conclusion:Preoperative hematoma thickness ≥ 20 mm is an independent predictor of recurrence of chronic subdural hematoma. Postoperative drainage also significantly reduces chronic subdural hematoma recurrence.

Comparisons of Radiological and Clinical Characteristics between Traumatic and Non-traumatic Subdural Hematoma Patients

“… 4) Patients with preoperative hematoma volumes <115 mL had a low recurrence rate, 19) while those with preoperative hematomas thicker than 20 mm had a higher recurrence rate. 1) In this study, there was no difference in hematoma thickness between the 2 groups.…”