Clinical Analysis of Risk Factors for Recurrence in Patients with Chronic Subdural Hematoma Undergoing Burr Hole Trephination
Korean Journal of Neurotrauma 2014³â 10±Ç 1È£ p.15 ~ p.21
(Jeong Seong-Il) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Neurosurgery
±è½Ã¿Â(Kim Si-On) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Neurosurgery
¿øÀ¯»ï(Won Yu-Sam) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Neurosurgery
±Ç¿µÁØ(Kwon Young-Joon) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Neurosurgery
ÃÖõ½Ä(Choi Chun-Sik) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Neurosurgery
Abstract
ObjectivesChronic subdural hematoma (CSDH) is one of the most common types of intra-cranial hemorrhages usually associated with trauma. Surgical treatment is the treatment of choice and burr hole trephination (BHT) is widely performed. The recurrence rate in the patients with CSDH is 3.7-30%. This study investigated the risk factors associated with the recurrence of patients with CSDH who underwent BHT.
Methods: One hundred twenty-five patients with CSDH underwent BHT. Eight of 125 patients (6.4%) underwent reoperation for recurrent CSDH. We retrospectively analyzed demographic, clinical and radiological findings, catheter tip location and drainage duration as the risk factors for the recurrence of CSDH.
Results: Recurrence of CSDH in the high- or mixed-density groups was significantly higher than those in the low- or iso-density groups (p<0.001). Placement of catheter tip at the temporoparietal area was associated with a significantly higher recurrence rate of CSDH than placement at the frontal area (p=0.006) and the brain re-expansion rate (BRR) was much lower than placement at the frontal area (p<0.001).
Conclusion: The operation may be delayed in high- and mixed-density groups, unless severe symptoms or signs are present. In addition, placing the catheter tip at the frontal area helps to reduce the incidence of postoperative recurrence of CSDH and to increase the BRR.
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Chronic subdural hematoma, Recurrence, Catheter tip location, Computed tomography
KMID :
1143720140100010015
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