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Efficacy of Arachnoid-Plasty on Chronic Subdural Hematoma Following Surgical Clipping of unruptured intracranial aneurysms

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Affiliated Author(s)
김창현이창영
Alternative Author(s)
Kim, Chang HyunLee, Chang Young
Journal Title
World Neurosugery
ISSN
1878-8750
Issued Date
2017
Keyword
Arachnoid plastyChronic subdural hematomaSubdural fluid collectionSurgical clippingUnruptured aneurysm
Abstract
BACKGROUND: We aimed to elucidate the effects of
arachnoid plasty (ARP) on chronic subdural hematoma
(CSDH) occurrence following clipping surgery.
- METHODS: In total 217 patients (ARP, n [ 97; non-ARP,
n [ 120) who had undergone unruptured intracranial
aneurysm (UIA) surgical clipping via the pterional
approach were retrospectively assessed. Predisposing
factors for CSDH development following the surgery were
investigated. Thickness and volume of the subdural fluid
collection (SDFC) were measured to determine whether
ARP affects postoperative SDFC.
- RESULTS: The occurrence of postoperative CSDH was
higher in patients without ARP compared to those with ARP
(12.5 vs. 3.1%; P[0.01). In multivariate analyses, having an
SDFC volume ‡15 mL on postoperative day (POD) 8, (odds
ratio [OR] [ 15.113; range [ 3.159e72.290), and male sex
(OR [ 4.274; range [ 1.291e14.148) were identified as
independent predictive factors. Having had ARP (OR [
0.228; range [ 0.056e0.927) was, as an independent variable,
negatively correlated with the occurrence of CSDH
(P < 0.05). Moreover, SDFC volume ‡15 ml on POD 8 was
significantly less common in the ARP group compared with
the non-ARP group (P [ 0.03).
- CONCLUSION: Patients who underwent ARPs developed
fewer CSDHs following UIA clipping surgery. The factors
that predicted the development of CSDH included male sex,
SDFC volume on POD 8, and ARP. In addition, the ARP
patients had lower SDFC volumes (<15 mL). These findings
suggested that ARP reduced the incidence of CSDHs after
surgical clippings in patients with unruptured aneurysms
Department
Dept. of Neurosurgery (신경외과학)
Publisher
School of Medicine
Citation
Jae-Hyun Kim et al. (2017). Efficacy of Arachnoid-Plasty on Chronic Subdural Hematoma Following Surgical Clipping of unruptured intracranial aneurysms. World Neurosugery, 104, 303–310. doi: 10.1016/j.wneu.2017.04.162
Type
Article
ISSN
1878-8750
DOI
10.1016/j.wneu.2017.04.162
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32871
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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