Radiological Features and Post-Operative Drainage Amount Independently Predict Recurrence of Chronic Subdural Hematoma after Burr-hole Craniostomy
|Chun-Yu Cheng1, Yu-Kai Cheng4, Chia-Yu Hsu2, Ting-Chung Wang1, Hsiu-Chu Lin1, Ming-Hsueh Lee1,
Sheng-Wei Chang3, Hsu-Huei Weng3, Yuan-Hsiung Tsai3, Tao-Chen Lee1 and Jen-Tsung Yang1*
|1 Department of Neurosurgery, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Tao-Yuan, Taiwan|
|2 Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Tao-Yuan, Taiwan|
|3 Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Tao-Yuan, Taiwan|
|4 Department of Neurosurgery, China Medical University and Hospital, College of Medicine, China Medical University, Taichung, Taiwan|
|Corresponding Author :||Jen-Tsung Yang
Department of Neurosurgery
Chang Gung Memorial Hospital
Chia-Yi Center, No 6, West Sec
Jiapu Road, Puzi City
Chia-Yi County, Taiwan
Tel: + 886-5-3621000-2864
Fax: + 886-5-3623002
E-mail: [email protected]
|Received February 15, 2014; Accepted February 26, 2014; Published February 28, 2014|
|Citation: Cheng CY, Cheng YK, Hsu CY, Wang TC, Lin HC, et al. (2014) Radiological Features and Post-Operative Drainage Amount Independently Predict Recurrence of Chronic Subdural Hematoma after Burr-hole Craniostomy. J Neurol Disord 2:148. doi: 10.4172/2329-6895.1000148|
|Copyright: © 2014 Cheng CY, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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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.
Methods: We retrospectively collected and analyzed data for 125 CSDH patients treated by burr-hole craniostomy in a regional hospital in Taiwan.
Results: Of these CSDH patients, the mean age was 70.2 ± 13.2 years and 96 (76.8%) were males. The CSDH recurrence rate after burr-hole craniostomy was 8.8% in our hospital. The recurrence group had thicker hematoma (24 mm vs. 18.5mm, P=0.024) and more often had laminar type CSDH (27.3% vs. 6.1%, P=0.044) than the non-recurrence group. Multivariate analysis found that thicker hematoma (P=0.033; OR=1.121; 95% CI 1.01-1.25), laminar type CSDH (P=0.010; OR=13.461; 95% CI 1.87-97.14) and larger total post-operative drainage amount (P=0.021; OR=1.002; 95% CI 1.000−1.004) were independently associated with recurrence of CSDH after burr-hole craniostomy. We didn’t find an association between burr hole numbers and recurrence rate.
Conclusion: We found thicker hematoma,laminar type CSDH and larger post-operative drainage amounts independently predict recurrence of CSDH after burr-hole craniostomy. The patients with these risk factors may need closer surveillance post-operatively. Further studies are needed for surgical method modification to achieve lower recurrence rate.