gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Article

Send article

Influence of Preoperative Hematoma Volume on Recurrence Rate in Chronic Subdural Hematoma

Meeting Abstract

Search Medline for

  • Claudia Unterhofer - Universitätsklinik für Neurochirurgie, Innsbruck, Austria
  • Marlies Bauer - Innsbruck, Austria
  • Claudius Thomé - A.ö. Landeskrankenhaus - Universitätskliniken Innsbruck, Tirol Kliniken GmbH, Universitätsklinik für Neurochirurgie, Innsbruck, Austria

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.24.07

doi: 10.3205/17dgnc321, urn:nbn:de:0183-17dgnc3218

Published: June 9, 2017

© 2017 Unterhofer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Recurrence rates after surgery of chronic subdural hematoma (cSDH) range from 0.35% to 33%. Many factors have been discussed. The role of preoperative hematoma volume (POV) was not sufficiently investigated. The aim of this study was to determine wether the initial hematoma volume had an impact on recurrence rate.

Methods: The study was conducted as a retrospective trial between 2008-2010. We analyzed all patients with cSDH within this period (n=164), who were treated by burr-hole craniotomy and standardized postoperative management. Those with bilateral hematoma and insufficient radiological screening were excluded. 104 patients were eligible. POV and volume at follow-up (FUV) (4-6 weeks) were calculated with BrainLab iPlanNet 3.5.0. Statistical analysis was performed using SPSS.

Results: Mean patient age was 73.2 years (range 45-98). 68% of patients were male (n=71). 19.2% of patients needed a revision (n=20). Mean POV was 92.6 cm3 (range 17.3-211.21 cm3), mean FUV was 33.2 cm3 (range 0-188.2 cm3), mean air volume was 2.34 cm3 (range 0-49.4 cm3). A ROC analysis on POV was performed. A cut-off value of 71.19 cm3 (Likelihood-ratio 1.51) was determined.

Conclusion: The results of our study showed an 1.5-fold risk for recurrence after surgery in patients with a POV of more than 71 cm3. Moreover, it seems to be important to perform a volumetric assessment of the initial hematoma volume to determine those patients with an increased risk of recurrence. Regarding the measured volume, extensive observation of this cohort is recommended.