Abstract
Background Organized chronic subdural hematoma (CSDH) is a special type of CSDH. However, the
optimal surgical procedure has not been established. We present our experience here
to discuss the surgical procedure in treatment of organized CSDH.
Methods Thirty-three patients with organized CSDH were admitted between January 1, 2008 and
January 1, 2018. Age, gender, clinical symptoms, imaging data, type of surgical procedure,
Barthel index (BI), and postoperative complications were collected and retrospectively
analyzed. The BI was assessed both pre and postoperatively (1 week and 1 month after
surgery).
Results Overall, 14 patients underwent large craniotomy and 19 patients underwent small craniotomy.
No significant differences in gender, age, initial clinical symptoms, and preoperative
BI were found between the groups (p > 0.05). Among the 14 patients who underwent large craniotomy, 2 patients developed
epilepsy after the operation, while 1 patient had postoperative aphasia. None of the
patients had recurrence in 6 months postoperatively. Among the 19 patients who underwent
small craniotomy, 1 patient developed an acute subdural hematoma and 1 patient developed
aphasia. No obvious complications were found in the remaining 18 patients and none
of the 19 patients had recurrence in 6 months postoperatively. BI scores of the small
craniotomy group were significantly better than those of the large craniotomy group
at 1 week postoperatively (p < 0.05). However, there was no significant difference in the 1-month results (p > 0.05).
Conclusion According to our single-center experience, a small craniotomy for treating organized
CSDH can be considered as an alternative to a larger craniotomy.
Keywords
organized chronic subdural hematoma - surgical procedure - Barthel index - postoperative
complication
