Non-acute subdural hematoma: estimation of recurrence using CT-volumetric measurements

Abstract

OBJECTIVES: To identify risk factors for unilateral non-acute subdural hematomas NASH recurrence, as well as to perform volumetric quantitative analysis of hematoma, postoperative pneumocephalus and extent of hematoma evacuation. BACKGROUND: Recurrence of NASH increases morbidity and mortality and has negative socio-economic consequences. Its accurate prediction could improve patient specifi c care. METHODS: Records of 102 patients after unilateral NASH evacuation during the period from 2014 to 2020 with a 4-month follow-up were evaluated. Impacts of preoperative clinical signs and factors on the incidence of NASH recurrence were evaluated, namely those of age, gender, timing of surgery, hematoma side, surgical technique (number of burr holes, trepanation versus craniotomy), duration of drainage, antithrombotic agents, morphological type of hematoma, preoperative hematoma volume (PHV), post-evacuation hematoma cavity volume (PHCV), pneumocephalus volume (PCV) and extent of hematoma evacuation (EHE) on the incidence of NASH recurrence were evaluated. RESULTS: An overall recurrence rate of 13.7 % was observed. Preoperative hematoma volume, postoperative hematoma cavity volume and postoperative pneumocephalus volume had a signifi cant impact on incidence of recurrence. CONCLUSIONS: Pre-and postoperative volumetric evaluations, of patients with NASH, particularly the measurements of preoperative hematoma volume and postoperative volume of hematoma cavity and pneumocephalus have a potential to improve the prediction of clinically signifi cant recurrence (Tab. 6, Fig. 3, Ref. 51).

Emerging Management of Chronic Subdural hematoma (CSDH) in High-Income Country (HIC) and Low-Income Country (LIC)

“…In low-resource settings, suboptimal surgical procedures due to a lack of resources, infrastructure, or trained personnel might contribute to higher recurrence rates. 32 8) Nutrition and Health Access: Malnutrition and poor overall health can weaken the body's ability to heal, potentially impacting the recurrence of CSDH. Limited access to nutritious food and healthcare in low-income countries can exacerbate this risk.…”