Recurrent chronic subdural hematoma: Evaluation of prognostic factors

W. H. Hsu, C. N. Chang*, T. K. Lin, J. T. Yang, K. C. Wei, Y. H. Hsu, J. Liao, H. L. Chen, H. L. Chuang, M. H. Li

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations

Abstract

Chronic subdural hematoma (CSDH) develops at variable recurrence rates despite of the use of different methods of surgical treatment. The purpose of the study is to evaluate the prognostic factors for recurrence. From July 1996 through June 1998, 105 consecutive operations for CSDH were reviewed. The patients' clinical presentations, brain CT images and methods of operation are analyzed to evaluate their associated risks of recurrence. Among those who presented with headache/or increased intracranial pressure (IICP) and hemiparesis, the odds ratio (OR) of recurrence was 0.44 and 2.27. In those whose CT images were hypodense CSDH and loculation/or septum formation, the OR was 1.94 and 2.84, respectively. The patients presenting with isodense CSDH had better outcomes, with an OR of 0.17. We performed external subdural drainage (ESD) in 30 operations, but the recurrence rate did not decreased in this group. Twelve patients were found with residual CSDH on the CT scan. They were conservatively managed with success. The recurrence rate was higher in patients with hemiparesis, hypodense CSDH and loculation/or septum formation. Headache/or IICP and isodensity were better prognostic factors for recurrence. External subdural drainage did not decrease the recurrence rate of CSDH. We suggest more conservative treatment during the initial management of patients with residual CSDH.

Original languageEnglish
Pages (from-to)24-30
Number of pages7
JournalActa Neurologica Taiwanica
Volume9
Issue number1
StatePublished - 2000
Externally publishedYes

Keywords

  • Burr hole craniostomy
  • Chronic subdural hematoma
  • External subdural drainage
  • Prognostic factors
  • Recurrence

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