Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Analysis of Risk Factor for the Development of Chronic Subdural Hematoma in Patients with Traumatic Subdural Hygroma

  • Ahn, Jun Hyong (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Jun, Hyo Sub (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Kim, Ji Hee (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Oh, Jae Keun (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Song, Joon Ho (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Chang, In Bok (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
  • Received : 2015.04.30
  • Accepted : 2016.07.21
  • Published : 2016.11.01
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Abstract

Objective : Although a high incidence of chronic subdural hematoma (CSDH) following traumatic subdural hygroma (SDG) has been reported, no study has evaluated risk factors for the development of CSDH. Therefore, we analyzed the risk factors contributing to formation of CSDH in patients with traumatic SDG. Methods : We retrospectively reviewed patients admitted to Hallym University Hospital with traumatic head injury from January 2004 through December 2013. A total of 45 patients with these injuries in which traumatic SDG developed during the follow-up period were analyzed. All patients were divided into two groups based on the development of CSDH, and the associations between the development of CSDH and independent variables were investigated. Results : Thirty-one patients suffered from bilateral SDG, whereas 14 had unilateral SDG. Follow-up computed tomography scans revealed regression of SDG in 25 of 45 patients (55.6%), but the remaining 20 patients (44.4%) suffered from transition to CSDH. Eight patients developed bilateral CSDH, and 12 patients developed unilateral CSDH. Hemorrhage-free survival rates were significantly lower in the male and bilateral SDG group (logrank test; p=0.043 and p=0.013, respectively). Binary logistic regression analysis revealed male (OR, 7.68; 95% CI 1.18-49.78; p=0.033) and bilateral SDG (OR, 8.04; 95% CI 1.41-45.7; p=0.019) were significant risk factors for development of CSDH. Conclusion : The potential to evolve into CSDH should be considered in patients with traumatic SDG, particularly male patients with bilateral SDG.

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References

  1. Apfelbaum RI, Guthkelch AN, Shulman K : Experimental production of subdural hematomas. J Neurosurg 40 : 336-346, 1974 https://doi.org/10.3171/jns.1974.40.3.0336
  2. Baechli H, Nordmann A, Bucher HC, Gratzl O : Demographics and prevalent risk factors of chronic subdural haematoma : results of a large single-center cohort study. Neurosurg Rev 27 : 263-266, 2004
  3. Caldarelli M, Di Rocco C, Romani R : Surgical treatment of chronic subdural hygromas in infants and children. Acta Neurochir (Wien) 144 : 581-588; discussion 588, 2002 https://doi.org/10.1007/s00701-002-0947-0
  4. Dandy WE : Treatment of an unusual subdural hydroma (external hydrocephalus). Arch Surg 52 : 421-428, 1946 https://doi.org/10.1001/archsurg.1946.01230050428003
  5. French BN, Cobb CA 3rd, Corkill G, Youmans JR : Delayed evolution of posttraumatic subdural hygroma. Surg Neurol 9 : 145-148, 1978
  6. Friede RL, Schachenmayr W : The origin ofsubdural neomembranes. II. Fine structural of neomembranes. Am J Pathol 92 : 69-84, 1978
  7. Fujioka S, Matsukado Y, Kaku M, Sakurama N, Nonaka N, Miura G : [CT analysis of 100 cases with chronic subdural hematoma with respect to clinical manifestation and the enlarging process of the hematoma (author's transl)]. Neurol Med Chir (Tokyo) 21 : 1153-1160, 1981 https://doi.org/10.2176/nmc.21.1153
  8. Hasegawa M, Yamashima T, Yamashita J, Suzuki M, Shimada S : Traumatic subdural hygroma : pathology and meningeal enhancement on magnetic resonance imaging. Neurosurgery 31 : 580-585, 1992 https://doi.org/10.1227/00006123-199209000-00024
  9. Kaufman HH, Childs TL, Wagner KA, Bernstein DP, Karon M, Khalid M, et al. : Post-traumatic subdural hygromas : observations concerning a surgical enigma. Acta Neurochir (Wien) 72 : 197-209, 1984 https://doi.org/10.1007/BF01406870
  10. Kawaguchi T, Fujita S, Hosoda K, Shibata Y, Komatsu H, Tamaki N : Treatment of subdural effusion with hydrocephalus after ruptured intracranial aneurysm clipping. Neurosurgery 43 : 1033-1039, 1998 https://doi.org/10.1097/00006123-199811000-00017
  11. Kawano N, Endo M, Saito M, Yada K : [Origin of the capsule of a chronic subdural hematoma--an electron microscopy study]. No Shinkei Geka 16 : 747-752, 1988
  12. Lee KS, Bae WK, Bae HG, Yun IG : The fate of traumatic subdural hygroma in serial computed tomographic scans. J Korean Med Sci 15 : 560-568, 2000 https://doi.org/10.3346/jkms.2000.15.5.560
  13. Lee KS, Bae WK, Park YT, Yun IG : The pathogenesis and fate of traumatic subdural hygroma. Br J Neurosurg 8 : 551-558, 1994 https://doi.org/10.3109/02688699409002947
  14. Lee KS, Bae WK, Yoon SM, Doh JW, Bae HG, Yun IG : Location of the traumatic subdural hygroma : role of gravity and cranial morphology. Brain Inj 14 : 355-361, 2000 https://doi.org/10.1080/026990500120646
  15. Nakaguchi H, Tanishima T, Yoshimasu N : Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg 95 : 256-262, 2001 https://doi.org/10.3171/jns.2001.95.2.0256
  16. Ohno K, Suzuki R, Masaoka H, Matsushima Y, Inaba Y, Monma S : Role of traumatic subdural fluid collection in developing process of chronic subdural hematoma. Bull Tokyo Med Dent Univ 33 : 99-106, 1986
  17. Ohno K, Suzuki R, Masaoka H, Matsushima Y, Inaba Y, Monma S : Chronic subdural haematoma preceded by persistent traumatic subdural fluid collection. J Neurol Neurosurg Psychiatry 50 : 1694-1697, 1987 https://doi.org/10.1136/jnnp.50.12.1694
  18. Park CK, Choi KH, Kim MC, Kang JK, Choi CR : Spontaneous evolution of posttraumatic subdural hygroma into chronic subdural haematoma. Acta Neurochir (Wien) 127 : 41-47, 1994 https://doi.org/10.1007/BF01808545
  19. Park SH, Lee SH, Park J, Hwang JH, Hwang SK, Hamm IS : Chronic subdural hematoma preceded by traumatic subdural hygroma. J Clin Neurosci 15 : 868-872, 2008 https://doi.org/10.1016/j.jocn.2007.08.003
  20. Sambasivan M : An overview of chronic subdural hematoma : experience with 2300 cases. Surg Neurol 47 : 418-422, 1997 https://doi.org/10.1016/S0090-3019(97)00188-2
  21. Schachenmayr W, Friede RL : The origin of subdural neomembranes. I. Fine structure of the dura-arachnoid interface in man. Am J Pathol 92 : 53-68, 1978
  22. Sohn IT, Lee KS, Doh JW, Bae HG, Yun IG, Byun BJ : A prospective study on the incidence, patterns and premorbid conditions of traumatic subdural hygroma. J Korean Neurosurg Soc 26 : 87-93, 1997
  23. Sousa EB, Brandao LF, Tavares CB, Borges IB, Neto NG, Kessler IM : Epidemiological characteristics of 778 patients who underwent surgical drainage of chronic subdural hematomas in Brasilia, Brazil. BMC Surg 13 : 5, 2013 https://doi.org/10.1186/1471-2482-13-5
  24. Spallone A, Giuffre R, Gagliardi FM, Vagnozzi R : Chronic subdural hematoma in extremely aged patients. Eur Neurol 29 : 18-22, 1989 https://doi.org/10.1159/000116370
  25. Stone JL, Lang RG, Sugar O, Moody RA : Traumatic subdural hygroma. Neurosurgery 8 : 542-550, 1981 https://doi.org/10.1227/00006123-198105000-00005
  26. Watanabe S, Shimada H, Ishii S : Production of clinical form of chronic subdural hematoma in experimental animals. J Neurosurg 37 : 552-561, 1972 https://doi.org/10.3171/jns.1972.37.5.0552
  27. Yamada H, Nihei H, Watanabe T, Shibui S, Murata S : [Chronic subdural hematoma occurring consequently to the posttraumatic subdural hygroma--on the pathogenesis of the chronic subdural hematoma (author's transl)]. No To Shinkei 31 : 115-121, 1979

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