Bilateral chronic subdural hematoma : a comparative study of recurrent and non-recurrent hematomas

Yamada Tetsuhisa, Natori Yoshihiro

doi:10.32187/neurotraumatology.41.1_16

Background: Chronic subdural hematoma is one of the most common diseases encountered in neurosurgical practice. Although treatment methods are well established, factor leading to recurrence remain unclear.Methods: To identify recurrence factors, we compared the clinical features of recurrent and non–recurrent hematomas in patients with bilateral chronic subdural hematoma. We retrospectively analyzed data for 23 patients (46 hematomas) who had undergone burr–hole surgery between January 2000 and December 2016. Recurrence was defined as the time at which hematoma recurrence warranted re–drainage.Results: The recurrence factors identified were post–operative hematoma volume and density. These bilateral surgical hematoma patients had same patient backgrounds and histories. No significant difference in degree of paralysis, and volume and density of hematoma pre–operatively in those with recurrent hematoma was observed.Conclusions: In recurrent hematoma, the density of the hematoma increased, and the hematoma volume showed an increasing trend one week post–operatively. In order to prevent the recurrence of chronic subdural hematoma, it is necessary to improve the return of the brain the next day after the operation by removing the hematoma as much as possible with surgery and postoperative drainage. In addition, within one week after surgery, taking measures against elevation of hematoma and increase of hematoma density are required. Especially, it is necessary for intervention in cases where return of the brain is not good with the head CT of the next day after surgery.

Bilateral chronic subdural hematoma : a comparative study of recurrent and non-recurrent hematomas

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