Identification of Radiological and Clinical Factors that Increase the Risk of Chronic Subdural Hematoma Recurrence

Turk Neurosurg. 2023;33(6):990-995. doi: 10.5137/1019-5149.JTN.40343-22.5.

Abstract

Aim: To determine risk factors predicting chronic subdural hematoma (CSH) recurrence is a common type of intracranial hemorrhage in elderly patients. Despite improved medical diagnosis and treatment, the reoperation rate remains high.

Material and methods: A retrospective review of 291 CSH patients admitted to our department was performed. Clinical and radiological factors predictive for CSH recurrence were identified by univariate analyses; variables whose p-value was < 0.05 underwent multivariate logistic regression analyses.

Results: Univariate analyses revealed that preoperative midline shift (p=0.025), mix-density hematoma (p=0.023), internal architecture of hematoma (p=0.044), membranectomy (p=0.001), and ambient cistern compression (p=0.001) correlated with a significantly higher rate of recurrence. Multivariate analyses showed that separated architecture, membranectomy and ambient cistern compression were independent risk factors for CSH recurrence.

Conclusion: Among many factors, membranectomy, separated architecture, and ambient cistern compression were the strongest predictors for recurrence.

MeSH terms

  • Aged
  • Craniotomy / adverse effects
  • Hematoma, Subdural, Chronic* / diagnostic imaging
  • Hematoma, Subdural, Chronic* / surgery
  • Humans
  • Neurosurgical Procedures / adverse effects
  • Radiography
  • Recurrence
  • Retrospective Studies
  • Risk Factors