J Korean Neurotraumatol Soc.  2005 Oct;1(1):46-50. 10.13004/jknts.2005.1.1.46.

Clinical Evaluation of Bilateral Chronic Subdural Hematoma: Characteristic Findings and Significance of Postoperative Drainage Amount

• Kim JH
• Kwon TH
• Han S
• Kim JH
• Park YK
• Chung HS

• KMID: 2192308
• DOI: http://doi.org/10.13004/jknts.2005.1.1.46

Abstract

OBJECTIVE
Even though bilateral chronic subdural hematoma (CSDH) constitutes about 15% to 20% of all CSDH, relatively scanty data have been demonstrated. We retrospectively reviewed clinical manifestations and postoperative drainage volumes of bilateral CSDH patients, and compared them with those of unilateral CSDH.
METHODS
A total of 50 cases of bilateral CSDH were retrospectively investigated. Of these, 45 patients had surgery: 37 patients for both sides and 8 patients for symptomatic sides only. Burr-hole craniotomies with irrigation and closed-system drainage were performed in all patients for 5 days.
RESULTS
In compared with unilateral CSDH, symptoms of headache and numbers of patients with predisposing factors found in more frequently in bilateral ones. Most of the bilaterally operated cases, drainage volumes of each side were largely different and it was significantly related to older age. There were 4 recurrences, which were not related to differences of drainage amount, but with low volumes of drainage. In addition, in patients operated symptomatic sides only, two cases had to be operated on the other sides later for enlarging hematomas.
CONCLUSION
In bilateral CSDH cases, symptoms of headache and predisposing factors are more common than unilateral ones. Postoperative drainage volumes on each side of bilateral CSDH are largely different in most cases and age seems to attribute to this finding. Additionally, relatively large numbers(25%) of unilaterally operated cases needed additional surgery on opposite side, so careful follow-up study should be considered.

Keyword

Subdural hematoma; Drainage volume; Recurrence

MeSH Terms

Causality
Craniotomy
Drainage*
Follow-Up Studies
Headache
Hematoma
Hematoma, Subdural
Hematoma, Subdural, Chronic*
Humans
Recurrence
Retrospective Studies