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http://dx.doi.org/10.3340/jkns.2016.1010.003

Predictive Factors for Recurrence after Burr-Hole Craniostomy of Chronic Subdural Hematoma  

Kim, Sang Uk (Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Lee, Dong Hoon (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
Kim, Young Il (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
Yang, Seung Ho (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
Sung, Jae Hoon (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
Cho, Chul Bum (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
Publication Information
Journal of Korean Neurosurgical Society / v.60, no.6, 2017 , pp. 701-709 More about this Journal
Abstract
Objective : Chronic subdural hematoma is a common and relatively benign disease. However, recurrence is common after surgical treatment, and the recurrence rate varies from 5% to 33%. The aim of this study was to investigate the predictive factors for recurrence of chronic subdural hematoma. Methods : We analyzed data from 248 patients with chronic subdural hematoma who were treated by burr-hole craniostomy with a closed drainage system for hematoma evacuation in this five-year retrospective study. Results : Thirty-one (12.6%) patients underwent re-operation for recurrence of chronic subdural hematoma. Univariate analysis revealed that anticoagulation (p=0.0279), headache (p=0.0323), and preoperative midline shifting (p=0.0321) showed significant differences with respect to recurrent chronic subdural hematoma. We performed a multivariate logistic regression analysis and found that diabetes mellitus (odds ratio [OR], 2.618; 95% confidence interval [CI], 1.0899-6.2898; p=0.0314), anticoagulation (OR, 6.739; 95% CI, 1.1287-40.2369; p=0.0364), headache (OR, 2.951; 95% CI, 1.1464-7.5964; p=0.0249), and preoperative midline shifting (OR, 1.0838; 95% CI, 1.0040-1.1699; p=0.0391) were independent predictive factors for recurrence of chronic subdural hematoma. Conclusion : We showed that diabetes mellitus, anticoagulation, headache, and preoperative midline shifting were independent predictors of recurrence of chronic subdural hematoma.
Keywords
Recurrence; Hematoma, Subdural, Chronic; Multivariate analysis;
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1 Harper L, Barkhof F, Fox NC, Schott JM : Using visual rating to diagnose dementia: a critical evaluation of MRI atrophy scales. J Neurol Neurosurg Psychiatry 86 : 1225-1233, 2015   DOI
2 Huang YH, Yang KY, Lee TC, Liao CC : Bilateral chronic subdural hematoma: what is the clinical significance? Int J Surg 11 : 544-548, 2013   DOI
3 Jung YG, Jung NY, Kim E : Independent predictors for recurrence of chronic subdural hematoma. J Korean Neurosurg Soc 57 : 266-270, 2015   DOI
4 Kayaci S, Kanat A, Koksal V, Ozdemir B : Effect of inner membrane tearing in the treatment of adult chronic subdural hematoma: a comparative study. Neurol Med Chir (Tokyo) 54 : 363-373, 2014   DOI
5 Lee JK, Choi JH, Kim CH, Lee HK, Moon JG : Chronic subdural hematomas : a comparative study of three types of operative procedures. J Korean Neurosurg Soc 46 : 210-214, 2009   DOI
6 Lega BC, Danish SF, Malhotra NR, Sonnad SS, Stein SC : Choosing the best operation for chronic subdural hematoma: a decision analysis. J Neurosurg 113 : 615-621, 2010   DOI
7 Cenic A, Bhandari M, Reddy K : Management of chronic subdural hematoma: a national survey and literature review. Can J Neurol Sci 32 : 501-506, 2005   DOI
8 Cheung N, Mitchell P, Wong TY : Diabetic retinopathy. Lancet 376 : 124-136, 2010   DOI
9 Chon KH, Lee JM, Koh EJ, Choi HY : Independent predictors for recurrence of chronic subdural hematoma. Acta Neurochir (Wien) 154 : 1541-1548, 2012   DOI
10 Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, DeRosa PL, Andersen KN, et al. : Erratum to: the surgical management of chronic subdural hematoma. Neurosurg Rev 38 : 771-771, 2015   DOI
11 El-Kadi H, Miele VJ, Kaufman HH : Prognosis of chronic subdural hematomas. Neurosurg Clin N Am 11 : 553-567, 2000
12 Nakaguchi H, Tanishima T, Yoshimasu N : Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage. J Neurosurg 93 : 791-795, 2000   DOI
13 Lind CR, Lind CJ, Mee EW : Reduction in the number of repeated operations for the treatment of subacute and chronic subdural hematomas by placement of subdural drains. J Neurosurg 99 : 44-46, 2003   DOI
14 Lindvall P, Koskinen LO : Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas. J Clin Neurosci 16 : 1287-1290, 2009   DOI
15 Markwalder TM : Chronic subdural hematomas: a review. J Neurosurg 54 : 637-645, 1981   DOI
16 Ohba S, Kinoshita Y, Nakagawa T, Murakami H : The risk factors for recurrence of chronic subdural hematoma. Neurosurg Rev 36 : 145-149; discussion 149-150, 2013   DOI
17 Oishi M, Toyama M, Tamatani S, Kitazawa T, Saito M : Clinical factors of recurrent chronic subdural hematoma. Neurol Med Chir (Tokyo) 41 : 382-386, 2001   DOI
18 Okada Y, Akai T, Okamoto K, Iida T, Takata H, Iizuka H : A comparative study of the treatment of chronic subdural hematoma--burr hole drainage versus burr hole irrigation. Surg Neurol 57 : 405-409; discussion 410, 2002   DOI
19 Park HR, Lee KS, Shim JJ, Yoon SM, Bae HG, Doh JW : Multiple densities of the chronic subdural hematoma in CT scans. J Korean Neurosurg Soc 54 : 38-41, 2013   DOI
20 Quinones-Hinojosa A, Gulati M, Singh V, Lawton MT : Spontaneous intracerebral hemorrhage due to coagulation disorders. Neurosurg Focus 15 : E3, 2003
21 Ramachandran R, Hegde T : Chronic subdural hematomas--causes of morbidity and mortality. Surg Neurol 67 : 367-372; discussion 372-373, 2007   DOI
22 Ro HW, Park SK, Jang DK, Yoon WS, Jang KS, Han YM : Preoperative predictive factors for surgical and functional outcomes in chronic subdural hematoma. Acta Neurochir (Wien) 158 : 135-139, 2016   DOI
23 Robinson RG : Chronic subdural hematoma: surgical management in 133 patients. J Neurosurg 61 : 263-268, 1984   DOI
24 Schwarz F, Loos F, Dunisch P, Sakr Y, Safatli DA, Kalff R, et al. : Risk factors for reoperation after initial burr hole trephination in chronic subdural hematomas. Clin Neurol Neurosurg 138 : 66-71, 2015   DOI
25 Spallone A, Giuffre R, Gagliardi FM, Vagnozzi R : Chronic subdural hematoma in extremely aged patients. Eur Neurol 29 : 18-22, 1989   DOI
26 Stanisic M, Lund-Johansen M, Mahesparan R : Treatment of chronic subdural hematoma by burr-hole craniostomy in adults: influence of some factors on postoperative recurrence. Acta Neurochir (Wien) 147 : 1249-1256; discussion 1256-1257, 2005   DOI
27 Tanaka Y, Ohno K : Chronic subdural hematoma - an up-to-date concept. J Med Dent Sci 60 : 55-61, 2013
28 Torihashi K, Sadamasa N, Yoshida K, Narumi O, Chin M, Yamagata S : Independent predictors for recurrence of chronic subdural hematoma: a review of 343 consecutive surgical cases. Neurosurgery 63 : 1125-1129; discussion 1129, 2008   DOI
29 Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S : Independent predictors of recurrence of chronic subdural hematoma: results of multivariate analysis performed using a logistic regression model. J Neurosurg 98 : 1217-1221, 2003   DOI
30 Tugcu B, Tanriverdi O, Baydin S, Hergunsel B, Gunaldi O, Ofluoglu E, et al. : Can recurrence of chronic subdural hematoma be predicted? A retrospective analysis of 292 cases. J Neurol Surg A Cent Eur Neurosurg 75 : 37-41, 2014
31 Yamashima T, Yamamoto S, Friede RL : The role of endothelial gap junctions in the enlargement of chronic subdural hematomas. J Neurosurg 59 : 298-303, 1983   DOI
32 Yu GJ, Han CZ, Zhang M, Zhuang HT, Jiang YG : Prolonged drainage reduces the recurrence of chronic subdural hematoma. Br J Neurosurg 23 : 606-611, 2009   DOI
33 Baechli H, Nordmann A, Bucher HC, Gratzl O : Demographics and prevalent risk factors of chronic subdural haematoma: results of a large single-center cohort study. Neurosurg Rev 27 : 263-266, 2004
34 Abouzari M, Rashidi A, Rezaii J, Esfandiari K, Asadollahi M, Aleali H, et al. : The role of postoperative patient posture in the recurrence of traumatic chronic subdural hematoma after burr-hole surgery. Neurosurg 61 : 794-797; discussion 797, 2007   DOI
35 Amirjamshidi A, Abouzari M, Eftekhar B, Rashidi A, Rezaii J, Esfandiari K, et al. : Outcomes and recurrence rates in chronic subdural haematoma. Br J Neurosurg 21 : 272-275, 2007   DOI
36 Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G; American College of Chest Physicians : Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 133(6 Suppl) : 160S-198S, 2008   DOI
37 Brodbelt A, Warnke P : Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry 75 : 1209-1210; author reply 1210, 2004
38 Gorelick PB, Weisman SM : Risk of hemorrhagic stroke with aspirin use: an update. Stroke 36 : 1801-1807, 2005   DOI
39 Ernestus RI, Beldzinski P, Lanfermann H, Klug N : Chronic subdural hematoma: surgical treatment and outcome in 104 patients. Surg Neurol 48 : 220-225, 1997   DOI
40 Gelabert-Gonzalez M, Iglesias-Pais M, Garcia-Allut A, Martinez-Rumbo R : Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg 107 : 223-229, 2005   DOI
41 Hamilton MG, Frizzell JB, Tranmer BI : Chronic subdural hematoma: the role for craniotomy reevaluated. Neurosurg 33 : 67-72, 1993