Chronic Subdural Hematoma Prognostic Factors for Recurrence | ||||
| The Medical Journal of Cairo University | ||||
| Article 102, Volume 86, December, December 2018, Page 4199-4207 PDF (653.4 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2018.62804 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| NAGEEB M. AL-SHAYA, M.Sc.; AHMAD A. KILANI, M.D.; AHMAD F. SHERIF, M.D.; MOHAMMAD TAGHYAN, M.D. | ||||
| The Department of Neurosurgy, Faculty of Medicine, Assiut University, Assiut, Egypt | ||||
| Abstract | ||||
| Abstract Background: Chronic Subdural Hematoma (CSDH) is a common neurologic disease in elderly. It is not always a benign condition because high recurrence rate had been reported. Independent risk factors for CSDH recurrence, especially the surgical and post-operative factors, had not been sufficiently investigated. Aim of Study: To evaluate the outcome of CSDH after burr hole craniostomy and irrigation with closed system drainage, and to analyze the potential risk factors, emphasizing surgical and post-operative ones, for CSDH recurrence and comparing the results to others mentioned in literature. Methods: We retrospectively analysed data of 82 CSDH patients treated by burr hole(s) craniostomy and irrigation with close system drainage CSDH in Assuit University Hospital from July 2015 to July 2016. Results: Of these CSDH patients, the main age was 58.9 years and 85.4% were males. The CSDH recurrence rate after burr-hole craniostomy was 7.3% in our hospital. CSDH recurrence was significantly associated with diabetes mellitus (p=0.027), hypertension (p=0.021) and prolonged PT (p= 0.025). Moreover an increased CSDH recurrence rate was observed in the patient group that had a mixed type (p=0.047), separated (p=0.044), trabecular (p=0.025) and hematoma thickness more than 20mm (p=0.34) of the CSDH in the preoperative diagnostic imaging .Also there were increased recurrence rate in patients group that had postoperative residual hematoma (p<0.001). Conclusion: We found diabetes mellitus, hypertension, prolonged PT, mixed type hematoma, separated, trabecular internal architecture of hematoma, thickness of hematoma 20mm and post-operative residual hematoma independently predict recurrence of CSDH after burr hole(s) craniostomy. The patients with these risk factors may need closer surveil-lance post-operatively. | ||||
| Keywords | ||||
| Chronic subdural hematoma – Recurrence – Risk factor – Burrhole – Craniostomy | ||||
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