The Predictive Factors for Resolution of Chronic Subdural Hematoma after Burrhole Trephination with Closed Drainage

Kim, Jong Yeon; Paik, Seung Jung; Kim, Hun Joo; Pyen, Jhin Soo; Han, Yong Pyo; Whang, Kum

Abstract

OBJECTIVE
The aim of this study is to evaluate the outcome of chronic subdural hematoma by correlating the clinical characteristics and radioligical findings in the chronic subdural patients who underwent burrhole trephination with closed drainage.
METHODS
The clinical, radiological, and operative factors related to resolution of chronic subdural hematoma (CSDH) were analyzed in 42 patients with CSDH 50 hemispheres, treated by burrhole trephination with closed drainage. The correlation with resolution was evaluated using personal and clinical factors such as age, sex, history of seizure, alcohol abuse, DM; computed tomography (CT) findings such as hematoma density, brain atrophy and hematoma thickness; Operative findings such as postoperative residual air; and laboratory findings such as platelet counts, INR and blood glucose levels.
RESULTS
The non-total resolution group (NTR) included 35 hemispheres (70%) in 29 patients (69.1%) Density of hematoma on CT was classified into five types: low, iso, and high density, layering, mixed, and the incidence of total resolution was 85.7%, 81.3%, 60%, 71.4% and 53.3%, respectively. Brain atrophy, postoperative residual air and the location of drainage catheter tip were not associated with resolution of CSDH. But age of 60 less years, normal range INR, patients with DM, narrow hematoma thickness (<20 mm) and the absence of high density on CT scan were associated with total resolution of CSDH at 6 month follow up.
CONCLUSION
In our study, patients aged 60years of less, prolonged INR levels, patients with DM, narrow hematoma thickness (<20 mm), and the absence of high density on CT scan had a greater possibility of total resolution at 6 month.