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Predictors of acute intracranial hemorrhage and recurrence of chronic subdural hematoma following burr hole drainage

Authors
  • Chen, Fu Mei1
  • Wang, Ke2
  • Xu, Kang Li1
  • Wang, Li3
  • Zhan, Tian Xiang4
  • Cheng, Fei4
  • Wang, Hao4
  • Chen, Zuo-Bing4
  • Gao, Liang2
  • Yang, Xiao Feng1
  • 1 The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, China , Hangzhou (China)
  • 2 Tongji University, 301Yan Chang road, Shanghai, 200072, China , Shanghai (China)
  • 3 College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310016, China , Hangzhou (China)
  • 4 College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, China , Hangzhou (China)
Type
Published Article
Journal
BMC Neurology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Mar 13, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12883-020-01669-5
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundTo investigate predictors of postoperative acute intracranial hemorrhage (AIH) and recurrence of chronic subdural hematoma (CSDH) after burr hole drainage.MethodsA multicenter retrospective study of patients who underwent burr hole drainage for CSDH between January 2013 and March 2019.ResultsA total of 448 CSDH patients were enrolled in the study. CSDH recurrence occurred in 60 patients, with a recurrence rate of 13.4%. The mean time interval between initial burr hole drainage and recurrence was 40.8 ± 28.3 days. Postoperative AIH developed in 23 patients, with an incidence of 5.1%. The mean time interval between initial burr hole drainage and postoperative AIH was 4.7 ± 2.9 days. Bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independent predictors of recurrence in the multiple logistic regression analyses. Preoperative headache was an independent risk factor of postoperative AIH in the multiple logistic regression analyses, however, intraoperative irrigation reduced the incidence of postoperative AIH.ConclusionsThis study found that bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independently associated with CSDH recurrence. Clinical presentation of headache was the strongest predictor of postoperative AIH, and intraoperative irrigation decreased the incidence of postoperative AIH.

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