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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)
이창영김창현
Alternative Author(s)
Lee, Chang YoungKim, Chang Hyun
Journal Title
World Neurosurgery
ISSN
1878-8750
Issued Date
2017
Keyword
Arachnoid plastyChronic subdural hematomaSubdural fluid collectionSurgical clippingUnruptured 무뎌교느
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 = 3.159-72.290), and male sex (OR = 4.274; range = 1.291-14.148) were identified as independent predictive factors. Having had ARP (OR = 0.228; range = 0.056-0.927) 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 (의과대학)
Citation
Jae-Hyun Kim et al. (2017). Efficacy of Arachnoid-Plasty on Chronic Subdural Hematoma Following Surgical Clipping of Unruptured Intracranial Aneurysms. World Neurosurgery, 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/41229
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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