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Vol 3, No 2 (2018)
Original article
Published online: 2018-07-31
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Early reoperations in chronic subdural hematoma

Borys M. Kwinta1, Roger M. Krzyżewski1, Kornelia Kliś1, Marek Moskała1
DOI: 10.5603/MRJ.2018.0013
·
Medical Research Journal 2018;3(2):76-81.
Affiliations
  1. Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland, Botaniczna 3, 31-501 Kraków, Poland

open access

Vol 3, No 2 (2018)
ORIGINAL ARTICLES
Published online: 2018-07-31

Abstract

Background: The recurrence rate of chronic subdural hematoma (cSDH) is high and early reoperation is often required.

Aim: The aim of this study was to evaluate prognostic factors for early reoperation of chronic subdural hematomas (cSDH) treated by classical and minimally invasive approach. Materials and Methods: We retrospectively analyzed the medical history of 355 cSDH patients treated with formal craniotomy and minimally invasive burr hole craniostomy. We determined the potential predictors of early reoperations.

Results: A total of 33 (9.3%) patients required early reoperation. Those patients more often underwent craniotomies instead of burr hole craniostomies (36.4% vs. 62.7%, p < 0.01) and took steroids before hospitalization (3.0% vs. 0.3%, p = 0.04) than non-reoperated patients. Patients who had surgery on the right side were less likely to be reoperated (51.9% vs. 33.3%, p = 0.04). On multivariate analysis the frontal (OR = 5.284, 95% CI: 1.293–21.76, p = 0.019) and large craniotomy (OR = 2.297, 95% CI: 1.004–5.258, p = 0.048) remained independent risk factors for early reoperation of cSDH.

Conclusions: Neurosurgeons should consider the evacuation of a cSDH with help of minimally invasive burr hole craniostomy in most of the cases, as well as avoid large and frontal and craniotomies in order to prevent early reoperation of cSDH.

Abstract

Background: The recurrence rate of chronic subdural hematoma (cSDH) is high and early reoperation is often required.

Aim: The aim of this study was to evaluate prognostic factors for early reoperation of chronic subdural hematomas (cSDH) treated by classical and minimally invasive approach. Materials and Methods: We retrospectively analyzed the medical history of 355 cSDH patients treated with formal craniotomy and minimally invasive burr hole craniostomy. We determined the potential predictors of early reoperations.

Results: A total of 33 (9.3%) patients required early reoperation. Those patients more often underwent craniotomies instead of burr hole craniostomies (36.4% vs. 62.7%, p < 0.01) and took steroids before hospitalization (3.0% vs. 0.3%, p = 0.04) than non-reoperated patients. Patients who had surgery on the right side were less likely to be reoperated (51.9% vs. 33.3%, p = 0.04). On multivariate analysis the frontal (OR = 5.284, 95% CI: 1.293–21.76, p = 0.019) and large craniotomy (OR = 2.297, 95% CI: 1.004–5.258, p = 0.048) remained independent risk factors for early reoperation of cSDH.

Conclusions: Neurosurgeons should consider the evacuation of a cSDH with help of minimally invasive burr hole craniostomy in most of the cases, as well as avoid large and frontal and craniotomies in order to prevent early reoperation of cSDH.

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Keywords

reoperation, minimally invasive approach, chronic subdural hematoma, burr hole, craniotomy

About this article
Title

Early reoperations in chronic subdural hematoma

Journal

Medical Research Journal

Issue

Vol 3, No 2 (2018)

Article type

Original article

Pages

76-81

Published online

2018-07-31

Page views

697

Article views/downloads

845

DOI

10.5603/MRJ.2018.0013

Bibliographic record

Medical Research Journal 2018;3(2):76-81.

Keywords

reoperation
minimally invasive approach
chronic subdural hematoma
burr hole
craniotomy

Authors

Borys M. Kwinta
Roger M. Krzyżewski
Kornelia Kliś
Marek Moskała

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