Korean J Neurotrauma.  2016 Oct;12(2):94-100. 10.13004/kjnt.2016.12.2.94.

Correlation between Head Trauma and Outcome of Chronic Subdural Hematoma

• Kim DH
• Park ES
• Kim MS
• Park SH
• Park JB
• Kwon SC
• Lyo IU
• Sim HB

• KMID: 2356780
• DOI: http://doi.org/10.13004/kjnt.2016.12.2.94

Abstract

OBJECTIVE
Our study examined the prognostic factors involved in the outcome of patients with chronic subdural hematoma (CSDH) who had undergone burr hole drainage procedures, and investigated the association between outcome and traumatic head injury. In addition, we explored factors related to recurrence.
METHODS
This study enrolled 238 patients with CSDH who had undergone burr hole drainage. Patients with history of head injury were categorized into the head trauma group and were compared with the no head trauma group. Outcome was considered good when modified Rankin Scale scores improved from admission to discharge and the final follow-up.
RESULTS
Among 238 patients, 127 (53.4%) were included in the head trauma group. One hundred thirty-three (55.9%) patients demonstrated good outcome at discharge, and 171 (71.8%) patients demonstrated good outcome at the final follow-up. None of the factors examined was significantly correlated with good outcome at discharge. However, only history of head injury (p=0.033, odds ratio 0.511, 95% confidence interval 0.277-0.946) was significantly correlated with poor outcome at long-term follow-up. Recurrence occurred in 20 (8.4%) cases in the total cohort and 11 (55%) patients in the head trauma group.
CONCLUSION
History of head trauma is correlated with poor outcome at long-term follow-up in CSDH patients having undergone burr hole drainage. Therefore, CSDH patients with history of head injury are susceptible to poor outcome, warranting more careful evaluation and treatment after burr hole drainage.

Keyword

Craniocerebral trauma; Critical care outcomes; Hematoma; Subdural; Chronic; Recurrence

MeSH Terms

Cohort Studies
Craniocerebral Trauma*
Critical Care Outcomes
Drainage
Follow-Up Studies
Head*
Hematoma
Hematoma, Subdural, Chronic*
Humans
Odds Ratio
Recurrence

Figure

• 

  FIGURE 1 A 40-year-old man with chronic subdural hematoma underwent burr hole drainage. (A) Pre-operative brain computed tomography (CT; 23-mm hematoma thickness, 12-mm midline shifting). (B) Post-operative brain CT (Post-operative epidural hematoma was seen).

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