No Value of Routine Brain Computed Tomography 6 Weeks after Evacuation of Chronic Subdural Hematoma
31 March 2017
28 August 2017
27 November 2017 (online)
Background The aim of this study was to evaluate the value of planned control postoperative brain computed tomography (CT) scan performed 4 to 6 weeks after the evacuation of chronic subdural hematoma.
Materials and Methods This retrospective study examined 202 patients who during a 2-year period from 2011 and 2012 underwent surgical treatment for chronic subdural hematoma (CSDH). Information on patient age, sex, alcohol consumption, anticoagulant/antiplatelet treatment, history of head trauma, Glasgow coma scale (GCS), neurological symptoms, laterality of CSDH, and surgical technique was retrieved from patient charts.
Results Overall, 27 out of 202 patients had a recurrence of CSDH and re-evacuation of the hematoma was performed. In all patients recurrence of neurological symptoms preceded the planned postoperative control brain CT 4 to 6 weeks after primary surgery.
Conclusion Routinely postoperative control brain CT scan 4 to 6 weeks after the evacuation of a CSDH has no clinical value.
- 1 Santarius T, Kirkpatrick PJ, Ganesan D. , et al. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet 2009; 374 (9695): 1067-1073
- 2 Davarian Y, Hansen-Schwartz J, Sørensen P. Chronic subdural hematoma. Physiopathology and treatment [in Danish]. Ugeskr Laeger 2004; 166 (25) 2427-2430
- 3 Ducruet AF, Grobelny BT, Zacharia BE. , et al. The surgical management of chronic subdural hematoma. Neurosurg Rev 2012; 35 (02) 155-169 , discussion 169
- 4 Ohba S, Kinoshita Y, Nakagawa T, Murakami H. The risk factors for recurrence of chronic subdural hematoma. Neurosurg Rev 2013; 36 (01) 145-149 , discussion 149–150
- 5 MacFarlane MR, Weerakkody Y, Kathiravel Y. Chronic subdural haematomas are more common on the left than on the right. J Clin Neurosci 2009; 16 (05) 642-644
- 6 Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 2001; 41 (08) 371-381
- 7 Gelabert-González M, Iglesias-Pais M, García-Allut A, Martínez-Rumbo R. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg 2005; 107 (03) 223-229
- 8 Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry 2003; 74 (07) 937-943
- 9 Liu W, Bakker NA, Groen RJ. Chronic subdural hematoma: a systematic review and meta-analysis of surgical procedures. J Neurosurg 2014; 121 (03) 665-673
- 10 Rocchi G, Caroli E, Salvati M, Delfini R. Membranectomy in organized chronic subdural hematomas: indications and technical notes. Surg Neurol 2007; 67 (04) 374-380 , discussion 380