Risk factors for chronic subdural hematoma recurrence identified using quantitative computer-tomography analysis of hematoma volume and density.

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Risk factors for chronic subdural hematoma recurrence identified using quantitative computer-tomography analysis of hematoma volume and density.

World Neurosurg. 2016 Dec 22;:

Authors: Stavrinou P, Katsigiannis S, Lee JH, Hamisch C, Krischek B, Mpotsaris A, Timmer M, Goldbrunner R

Abstract
INTRODUCTION: Chronic subdural hematomas (CSDH), a common condition in the elderly, present a therapeutic challenge with recurrence rates of up to 33%. We focused on identifying specific prognostic factors for recurrence using quantitative analysis of hematoma volume and density.
METHODS: We retrospectively reviewed radiographic and clinical data of 227 CSDH in 195 consecutive patients who underwent evacuation of the hematoma through a single burr hole, two burr holes or a mini-craniotomy. To examine the relationship between hematoma recurrence and various clinical, radiological and surgical factors, we used quantitative image-based analysis to measure the hematoma and trapped air volumes as well the hematoma densities.
RESULTS: Thirty-five patients (17.9%) experienced a recurrence of their CSDH. Multivariate logistic regression analysis revealed that the percentage of the hematoma drained, and postoperative hematoma density were independent risk factors for recurrence. All three methods above were equally effective in draining the hematoma (71.7% vs 73.7% vs 71.9%) without observable differences in the postoperative air volume captured in the subdural space.
CONCLUSIONS: Quantitative image analysis provided evidence that the percentage of hematomas drained and the postoperative CSDH density are independent prognostic factors for subdural hematoma recurrence.

PMID: 28017760 [PubMed - as supplied by publisher]

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