gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Factors influencing recurrence in chronic subdural hematoma

Meeting Abstract

  • Y. Tahsim-Oglou - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • D. Hänggi - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • H.-J. Steiger - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • W. Stummer - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMI.08-05

DOI: 10.3205/09dgnc225, URN: urn:nbn:de:0183-09dgnc2253

Published: May 20, 2009

© 2009 Tahsim-Oglou et al.
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Outline

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Objective: Chronic subdural hematoma (cSDH) is a common diagnosis in neurosurgery. However, recurrences requiring repeat surgery are observed in 15 to 20% of case. With this retrospective analysis of patients, we searched for possible factors influencing the likelihood for recurrences in order to identify factors that might be influenced by surgical technique or management.

Methods: Ninety-eight patients treated for cSDH at our department between July 2006 and July 2007 formed the basis of this analysis. Patient history, symptoms, age, anticoagulation therapy, bilateral vs. unilateral location, pre- and postoperative blood coagulation studies, thrombocyte cell count, the number of burr holes and the amount of rinsing fluid as derived from OR protocols (rather than surgeon’s notes) were recorded. SPSS 15.0 was used for statistical review.

Results: Average age was 70 years. Of 98 patients, 16 suffered recurrences and were reoperated (16.3%). 20 patients hat bilateral cSDH (20.4%), 22 patients were anticoagulated with phenprocoumon (n=20.4%),12 patients received antithrombocytic therapy (22.4%). In 54 patients there had been prior head trauma (55.1%), whereas the others did not have this history. In patients without recurrence, the volume of rinsing fluid was 1414.5 ± 447 ml and 1212.5 ± 429.77 ml (n.s.). In multivariate nominal regression analysis, however, the volume of rinsing fluid was a significant, independent predictor of recurrence (p=0.005), as were age (p=0.02), bilateral location (p=0.044) and antithrombocytic therapy (p=0.047).

Conclusions: Our data demonstrate that rinsing volume is a significant and independent factor determining recurrence in cSDH. This factor may be directly influenced by the treating surgeon.