| Outcomes of Chronic Subdural Hematoma Treated by Two Bur-hole Craniostomy with Closed Drainage |
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Si-Hyuck Oh , Jung Ho Ko , Young Jin Kim , Sang-Koo Lee |
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Department of Neurosurgery, Dankook University School of Medicine, Cheonan, Korea |
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| Abstract |
Objective
The research compared the clinical presentations, etiologic factors, and outcomes of chronic subdural hematoma according to
patient age, factors affecting clinical outcomes, and long-term outcomes in Korean adults.
Methods
The researchers reviewed retrospectively the clinical and radiological databases of 259 cases of chronic subdural hematoma (CSDH)
that received surgical treatment between January 2000 and August 2010. Among them, 161 patients had clinical symptoms with CSDH located
in at least two lobar subdural spaces, such as front-temporal or temporo-parietal, and were treated by two bur-hole craniostomy with catheterization.
The patients were divided into two groups according to age and clinical outcome.
Results
Young aged group (<60 years old) was male predominant, and had frequently increased intracranial pressure (ICP) sign as presenting
symptoms and combined co-morbidity than old aged group (≥60 years old). Also, young aged group had thicker hematoma thickness of
pre-operation. These differences were statistically significant (p<0.05). Comparing between favorable outcome group (GOS > 3) and poor outcome
group (GOS ≤3), favorable outcome group presented increased intracranial pressure (ICP) sign as initial symptoms frequently and performed
re-operation infrequently. Additionally, favorable outcome group had thicker hematoma at pre-operation and post-operation than poor
outcome group. These results had statistically significant difference (p<0.05).
Conclusion
Age and presenting symptom might influence clinical outcome. Re-operation and thickness of hematoma at post-operation 7th day
might be prognostic factor of CSDH. Combined co-morbidity and abnormality of coagulation could not influence to the clinical outcome. |
| Key Words:
Chronic subdural hematomaㆍPrognostic factorㆍOutcomeㆍBur-hole craniostomy |
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