Journal of Korean Neurosurgical Society

  • 제59권5호
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  • Pages.458-465
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  • 2016
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Predicting Factors of Chronic Subdural Hematoma Following Surgical Clipping in Unruptured and Ruptured Intracranial Aneurysm

  • Kwon, Min-Yong (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kim, Chang-Hyun (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lee, Chang-Young (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine)
  • 투고 : 2016.03.09
  • 심사 : 2016.06.08
  • 발행 : 2016.09.01
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초록

Objective : The aim of this study is to analyze the differences in the incidence, predicting factors, and clinical course of chronic subdural hematoma (CSDH) following surgical clipping between unruptured (UIA) and ruptured intracranial aneurysm (RIA). Methods : We conducted a retrospective analysis of 752 patients (UIA : 368 and RIA : 384) who underwent surgical clipping during 8 years. The incidence and predicting factors of CSDH development in the UIA and RIA were compared according to medical records and radiological data. Results : The incidence of postoperative CSDH was higher in the UIA (10.9%) than in the RIA (3.1%) (p=0.000). In multivariate analysis, a high Hounsfield (HF) unit (blood clots) for subdural fluid collection (SFC), persistence of SFC ${\geq}5mm$ and male sex in the UIA and A high HF unit for SFC and SFC ${\geq}5mm$ without progression to hydrocephalus in the RIA were identified as the independent predicting factors for CSDH development (p<0.05). Conclusion : There were differences in the incidence and predicting factors for CSDH following surgical clipping between UIA and RIA. Blood clots in the subdural space and persistence of SFC ${\geq}5mm$ were predicting factors in both UIA and RIA. However, progression to hydrocephalus may have in part contributed to low CSDH development in the RIA. We suggest that cleaning of blood clots in the subdural space and efforts to minimize SFC ${\geq}5mm$ at the end of surgery is helpful to prevent CSDH following aneurysmal clipping.

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참고문헌

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피인용 문헌

  1. Study of Incidence and Factors: Risk and Preventive, of Chronic Subdural Hematoma/hygroma in Clipped Patients of Unruptured Intracranial Aneurysms – An Institutional Experience vol.13, pp.3, 2016, https://doi.org/10.4103/ajns.ajns_355_16
  2. Procedural Clinical Complications, Case-Fatality Risks, and Risk Factors in Endovascular and Neurosurgical Treatment of Unruptured Intracranial Aneurysms : A Systematic Review and Meta-analysis vol.76, pp.3, 2019, https://doi.org/10.1001/jamaneurol.2018.4165
  3. Racial and Ethnic Disparities in Treatment Outcomes of Patients with Ruptured or Unruptured Intracranial Aneurysms vol.6, pp.2, 2019, https://doi.org/10.1007/s40615-018-0530-x
  4. Arachnoid Plasty to Prevent and Reduce Chronic Subdural Hematoma after Clipping Surgery for Unruptured Intracranial Aneurysm : A Meta-Analysis vol.63, pp.4, 2016, https://doi.org/10.3340/jkns.2020.0036