Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
E-pub ahead of print

Risk factors for need of reoperation in bilateral chronic subdural haematomas

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Past, present and future, the experience of time during examination for malignant brain tumor: a qualitative observational study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Surgical occlusion of middle meningeal artery in treatment of chronic subdural haematoma: anatomical and technical considerations

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Long-term telemetric intracerebral pressure monitoring as a tool in intracranial hypotension

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Changes in intracranial pressure and pulse wave amplitude during postural shifts

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. TERT promoter mutations in primary and secondary WHO grade III meningioma

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. The Ki-67 Proliferation Index as a Marker of Time to Recurrence in Intracranial Meningioma

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Preoperative antibiotic prophylaxis regimen in brain tumour surgery in Sweden: a quasi-experimental study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Return to work following diagnosis of low-grade glioma: A nationwide matched cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Shaian Zolfaghari
  • Jiri Bartek
  • Felix Djärf
  • San-San Wong
  • Isabelle Strom
  • Nils Ståhl
  • Asgeir S Jakola
  • Henrietta Nittby Redebrandt
Vis graf over relationer

BACKGROUND: Chronic subdural haematoma (CSDH) is one of the most common neurosurgical diseases. A subtype of CSDH is bilateral chronic subdural haematoma (bCSDH) which represents 20-25% of patients with CSDH and has a higher recurrence rate. There is no clear consensus on how bCSDH should be treated regarding upfront unilateral- or bilateral evacuation of both haematomas. The purpose of this study was to identify risk factors associated with reoperation of bCSDH.

METHODS: A total of 326 patients with radiological evidence of bCSDH were included in this retrospective cohort study where 133 (40.8%) patients underwent primary bilateral evacuation and 193 (59.2%) primary unilateral evacuation. The two centres operated using different surgical approaches. Analyses were performed to identify risk factors associated with reoperation of bCSDH. Reoperation rate was defined as reoperation of CSDH on either side of the hemisphere within 3 months after primary evacuation.

RESULTS: The cohort had a total reoperation rate of 26.4%. Patients which underwent unilateral evacuation had a reoperation rate of 32.1%, and the bilateral group had a reoperation rate of 18.0% (p=0.005). Multivariable logistic regression identified unilateral evacuation (OR 1.91, p=0.022) and complications according to Ibanez (OR 2.20, p=0.032) to be associated with the need of reoperation of bCSDH. One-burr hole craniostomy with active subgaleal drain was primarily performed in bilateral approach (69.4%) whereas patients operated with minicraniotomy with passive subdural drain were primarily operated by unilateral evacuation of the larger symptomatic side (92.8%).

CONCLUSIONS: Unilateral evacuation of bCSDH was associated with a higher risk for reoperation than upfront bilateral evacuations in this study. There is a need to further discuss the criteria for uni- or bilateral evacuation since patients are treated differently at different centres.

OriginalsprogEngelsk
TidsskriftActa Neurochirurgica
ISSN0001-6268
DOI
StatusE-pub ahead of print - 2 apr. 2021

ID: 64686010