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Predicting Factors of Chronic Subdural Hematoma Following Surgical Clipping in Unruptured and Ruptured Intracranial Aneurysm

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Author(s)
Min-Yong KwonChang-Hyun KimChang-Young Lee
Keimyung Author(s)
Kim, Chang HyunLee, Chang Young
Department
Dept. of Neurosurgery (신경외과학)
Journal Title
Journal of Korean Neurosurgical Society
Issued Date
2016
Volume
59
Issue
5
Keyword
Chronic subdural hematomaSurgical clippingIntracranial aneurysm
Abstract
Objective : The aim of this study is to analyze the differences in the incidence, predicting factors, and clinical course of chronic subdural hematoma (CSDH) following surgical clipping between unruptured (UIA) and ruptured intracranial aneurysm (RIA).
Methods : We conducted a retrospective analysis of 752 patients (UIA : 368 and RIA : 384) who underwent surgical clipping during 8 years. The incidence and predicting factors of CSDH development in the UIA and RIA were compared according to medical records and radiological data.
Results : The incidence of postoperative CSDH was higher in the UIA (10.9%) than in the RIA (3.1%) (p=0.000). In multivariate analysis, a high Hounsfield (HF) unit (blood clots) for subdural fluid collection (SFC), persistence of SFC ≥5 mm and male sex in the UIA and A high HF unit for SFC and SFC ≥5 mm without progression to hydrocephalus in the RIA were identified as the independent predicting factors for CSDH development (p<0.05).
Conclusion : There were differences in the incidence and predicting factors for CSDH following surgical clipping between UIA and RIA. Blood clots in the subdural space and persistence of SFC ≥5 mm were predicting factors in both UIA and RIA. However, progression to hydrocephalus may have in part contributed to low CSDH development in the RIA. We suggest that cleaning of blood clots in the subdural space and efforts to minimize SFC ≥5 mm at the end of surgery is helpful to prevent CSDH following aneurysmal clipping.
Keimyung Author(s)(Kor)
김창현
이창영
Publisher
School of Medicine
Citation
Min-Yong Kwon et al. (2016). Predicting Factors of Chronic Subdural Hematoma Following Surgical Clipping in Unruptured and Ruptured Intracranial Aneurysm. Journal of Korean Neurosurgical Society, 59(5), 458–465. doi: 10.3340/jkns.2016.59.5.458
Type
Article
ISSN
2005-3711
DOI
10.3340/jkns.2016.59.5.458
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32463
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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