Factors Affecting Postoperative Recurrence of Chronic Subdural Hematoma

Chronic subdural hematoma (CSDH) is a relatively common disease, especially in the geriatric population, frequently encountered in neurosurgical practice. Formation of the outer membrane with an interior containing hyperosmolar blood collection causes development of CSDH, and the outer membrane has abnormally permeable microcapillaries leading to accumulation of exudation from the macrocapillaries in the outer membrane, therefore enlarging the area of the subdural hematoma. CSDHs have been reported to show good postoperative prognosis with relatively simple method of surgical treatment including burr hole trephination. Traditionally, burr hole trephination and evacuation of hematoma with closed drainage system has been widely accepted as the optimal treatment for CSDH. It is agreeable that surgical decompression offers a dramatic improvement of symptoms, and the procedure is relatively noninvasive and safe with satisfactory postoperative outcome in the majority of patients with CSDH. However, considerable recurrence rates have been reported ranging from 3 to 20% following surgical management. This clinical analysis evaluated the postoperative course of CSDH and the factors correlated with recurrence.