Volume and densities of chronic subdural haematoma obtained from CT imaging as predictors of postoperative recurrence: a prospective study of 107 operated patients

详细信息    查看全文

• 作者：Milo Stani?i? (1)
  John Hald (2)
  Inge Andre Rasmussen (3)
  Are Hugo Pripp (4)
  Jugoslav Ivanovi? (1)
  Frode Kolstad (1)
  Jarle Sundseth (1)
  Mark Züchner (1)
  Karl-Fredrik Lindegaard (1) (5)
  
• 关键词：Chronic subdural haematoma ; Computerised tomography ; Densities ; Multiple regression ; Recurrence ; Volume
• 刊名：Acta Neurochirurgica
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：155
• 期：2
• 页码：323-333
• 全文大小：402KB
• 参考文献：1. Weigel R, Schmiedek P, Krauss JK (2003) Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry 74:937-43 CrossRef
  2. Ko B-S, Lee J-K, Seo B-R, Moon S-J, Kim J-H, Kim S-H (2008) Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J Korean Neurosurg Soc 42:11-5 CrossRef
  3. Kurokawa Y, Ishizaki E, Inaba K (2005) Bilateral chronic subdural hematoma cases showing rapid and progressive aggravation. Surg Neurol 64:444-49 CrossRef
  4. Mori K, Maeda M (2001) Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 41:371-81 CrossRef
  5. Rust T, Kiemer N, Erasmus A (2006) Chronic subdural haematomas and anticoagulation or anti-thrombotic therapy. J Clin Neurosci 13:823-27 CrossRef
  6. Torihashi K, Sadamasa N, Yoshida K, Narumi O, Chin M, Yamagata S (2008) Independent predictors for recurrence of chronic subdural hematoma: a revive of 343 consecutive surgical cases. Neurosurgery 63:1125-129 CrossRef
  7. Tsai TH, Lieu AS, Hwang SL, Huang TY, Hwang YF (2010) A comparative study of the patients with bilateral or unilateral chronic subdural hematoma: precipitating factors and postoperative outcomes. J Trauma 68:571-75 CrossRef
  8. Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S (2003) Independent predictors of recurrence of chronic subdural hematoma: results of multivariate analysis performed using a logistic regression model. J Neurosurg 98:1217-221 CrossRef
  9. Yu GJ, Han CZ, Zhang M, Zhuang HT, Jiang YG (2009) Prolonged drainage reduces the recurrence of chronic subdural hematoma. Br J Neurosurg 23:606-11 CrossRef
  10. Baé ME, Wessling H, Salca HC, Echeverría PH (2011) Use of twist-drill craniostomy with drain in evacuation of chronic subdural hematomas: independent predictors of recurrence. Acta Neurochir (Wein) 153:1097-103 CrossRef
  11. Havenbergh TV, Calenbergh FV, Goffin J, Plets C (1996) Outcome of chronic subdural hematoma: analysis of prognostic factors. Br J Neurosurg 10:27-4 CrossRef
  12. Matsumoto K, Akagi K, Abekura M, Ryujin H, Ohkawa M, Iwasa N, Akiyama C (1999) Recurrence factors for chronic subdural hematomas after burr-hole craniostomy and closed system drainage. Neurol Res 21:277-80
  13. Stanisic M, Lund-Johansen M, Mahesparan R (2005) Treatment of chronic subdural hematoma by burr-hole craniostomy in adults: influence of some factors on postoperative recurrence. Acta Neurochir (Wien) 147:1249-256 CrossRef
  14. Taussky P, Fandino J, Landolt H (2008) Number of burr holes as independent predictor of postoperative recurrence in chronic subdural haematoma. Br J Neurosurg 22:279-82 CrossRef
  15. Delgado PD, Cogolludo FJ, Mateo O, Cancela P, Garcia R, Carrillo R (2000) Early prognosis in chronic subdural haematomas. Multivariate analysis of 137 cases. Rev Neurol 30:811-17
  16. Gelabert-González M, Iglesias-Pais M, García-Allut A, Martínez-Rumbo R (2005) Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg 107:223-29 CrossRef
  17. Nakaguchi H, Tanishima T, Yoshimasu N (2001) Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg 95:256-62 CrossRef
  18. Nomura S, Kashiwagi S, Fujisawa H, Ito H, Nakamura K (1994) Characterization of local hyperfibrinolysis in chronic subdural hematomas by SDS-PAGE and immunoblot. J Neurosurg 81:910-13 CrossRef
  19. Oishi M, Toyama M, Tamatani S, Kitazawa T, Saito M (2001) Clinical factors of recurrent chronic subdural hematoma. Neurol Med Chir (Tokyo) 41:382-86 CrossRef
  20. Tokmak M, Iplikcioglu AC, Bek S, G?kduman CA, Erdal M (2007) The role of exudation in chronic subdural hematomas. J Neurosurg 107:290-95 CrossRef
  21. Tsutsumi K, Maeda K, Iijima A, Usui M, Okada Y, Kirino T (1997) The relationship of preoperative magnetic resonance imaging findings and closed system drainage in the recurrence of chronic subdural hematoma. J Neurosurg 87:870-75 CrossRef
  22. Amirjamshidi A, Abouzari M, Eftekhar B, Rashidi A, Rezaii J, Esfandiari K, Shirani A, Asadollahi M, Aleali H (2007) Outcomes and recurrence rates in chronic subdural haematoma. Br J Neurosurg 21:272-75 CrossRef
  23. Lee KS, Bae WK, Doh JW, Bae HG, Yun IG (1998) Origin of chronic subdural haematoma and relation to traumatic subdural lesions. Brain Inj 12:901-10 CrossRef
  24. Okada Y, Akai T, Okamoto K, Iida T, Takata H, Iizuka H (2002) A comparative study of the treatment of chronic subdural hematoma- burr hole drainage versus burr hole irrigation. Surg Neurol 57:405-10 CrossRef
  25. Nakaguchi H, Yoshimasu N, Tanishima T (2003) Relationship between the natural history of chronic subdural hematoma and enhancement of the inner membrane on post-contrast CT scan [in Japanese with Eng abstract]. No Shinkei Geka 31:157-64
  26. Ramachandran R, Hegde T (2007) Chronic subdural hematomas- causes of morbidity and mortality. Surg Neurol 67:367-73 CrossRef
  27. Nakaguchi H, Tanishima T, Yoshimasu N (2000) Relationship between drainage catheter location and postoperative recurrence of chronic subdural hamatoma after burr-hole irrigation and closed-system drainage. J Neurosurg 93:791-95 CrossRef
  28. Sucu HK, Gokmen M, Gelal F (2005) The value of XYZ/2 technique compared with computer-assisted volumetric analysis to estimate the volume of chronic subdural hematoma. Stroke 36:998-000 CrossRef
  29. Sundstr?m T, Helland CA, Aarhus M, Wester K (2011) What is the pressure in chronic subdural hematomas? A prospective, population-based study. J Neurotrauma 28:1- CrossRef
  30. Spallone A, Giuffre R, Gagliardi FM, Vagnozzi R (1989) Chronic subdural hematoma in extremely aged patients. Eur Neurol 29:18-2 CrossRef
  31. Fukuhara T, Gotoh M, Asari S, Ohmoto T, Akioka T (1996) The relationship between brain surface elastance and brain reexpansion after evacuation of chronic subdural hematoma. Surg Neurol 45:570-74 CrossRef
  32. Shiomi N, Sasajima H, Mineura K (2001) Relationship of postoperative residual air and recurrence in chronic subdural hematoma [in Japanese with Eng abstract]. No Shinkei Geka 29:39-4
  33. Abouzari M, Roshidi A, Sodagari N, Aleall H, Behzadi M (2008) The relationship between the level of consciousness and sedimentation level in CT scan of chronic subdural hematoma. J Neuroimaging 18:463-64 CrossRef
  34. Fujisawa H, Nomura S, Tsuchida E, Ito H (1998) Serum protein exudation in chronic subdural hematomas: a mechanism for hematoma enlargement? Acta Neurochir (Wien) 140:161-66 CrossRef
  
• 作者单位：Milo Stani?i? (1)
  John Hald (2)
  Inge Andre Rasmussen (3)
  Are Hugo Pripp (4)
  Jugoslav Ivanovi? (1)
  Frode Kolstad (1)
  Jarle Sundseth (1)
  Mark Züchner (1)
  Karl-Fredrik Lindegaard (1) (5)
  
  1. Department of Neurosurgery, Oslo University Hospital, Nydalen, Po. Box 4950, 0424, Oslo, Norway
  2. Department of Radiology, Oslo University Hospital, Oslo, Norway
  3. Intervention Centre, Oslo University Hospital, Oslo, Norway
  4. Unit of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
  5. Faculty of Medicine, University of Oslo, Oslo, Norway
  

文摘

Background Chronic subdural haematoma (CSDH) is a common entity in neurosurgery with a considerable postoperative recurrence rate. Computerised tomography (CT) scanning remains the most important diagnostic test for this disorder. The aim of this study was to characterise the relationship between the recurrence of CSDH after treatment with burr-hole irrigation and closed-system drainage technique and CT scan features of these lesions to assess whether CT findings can be used to predict recurrence. Methods We investigated preoperative and postoperative CT scan features and recurrence rate of 107 consecutive adult surgical cases of CSDH and assessed any relationship with univariate and multivariate regression analyses. Results Seventeen patients (15.9?%) experienced recurrence of CSDH. The preoperative haematoma volume, the isodense, hyperdense, laminar and separated CT densities and the residual total haematoma cavity volume on the 1st postoperative day after removal of the drainage were identified as radiological predictors of recurrence. If the preoperative haematoma volume was under 115?ml and the residual total haematoma cavity volume postoperatively was under 80?ml, the probability of no recurrence was very high (94.4?% and 97.4?% respectively). Conclusions These findings from CT imaging may help to identify patients at risk for postoperative recurrence.