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Acta Neurochir (Wien). 2016 Jul;158(7):1241-6. doi: 10.1007/s00701-016-2820-6. Epub 2016 May 5.

Is systematic post-operative CT scan indicated after chronic subdural hematoma surgery? A case-control study.

Author information

1
Department of Neurosurgery, Caen University Hospital, Avenue de la Cote de Nacre, Caen, 14000, France.
2
INSERM, UMR-S U919, Serine Proteases and Pathophysiology of the neurovascular Unit, GIP Cyceron, University Caen Lower-Normandy, Bd Henri Becquerel, Caen, France.
3
Department of neuro-interventional radiology, Hôpital Pierre Wertheimer, Lyon, France.
4
Department of Anesthesiology and Intensive Care Medicine, Caen University Hospital, Avenue de la Cote de Nacre, Caen, France.
5
Department of Neurosurgery, Caen University Hospital, Avenue de la Cote de Nacre, Caen, 14000, France. thomas.gaberel@hotmail.fr.
6
INSERM, UMR-S U919, Serine Proteases and Pathophysiology of the neurovascular Unit, GIP Cyceron, University Caen Lower-Normandy, Bd Henri Becquerel, Caen, France. thomas.gaberel@hotmail.fr.

Abstract

BACKGROUND AND AIMS:

The aim of the present study was to evaluate the interest of systematic post-operative CT scan after unilateral chronic subdural hematoma (CSDH) evacuation. To achieve this goal, we chose to evaluate the ability of post-operative CT scan to predict the most frequent complication of CSDH: hematoma recurrence.

METHODS:

We performed a retrospective case-control study. Cases were defined as patients who had CSDH recurrence; controls were those who did not. We first studied clinical data and pre-operative CT scan data. We then studied post-operative CT scan data: hematoma thickness and its decrease, persistence of midline shift, its value and its decrease, and presence of compressive pneumocephalus.

RESULTS:

Among 654 patients, 15 were defined as cases, and were matched with 30 non-recurrent patients defined as controls. Regarding systematic post-operative CT scan findings, unilateral CSDH recurrence was clearly associated with the persistence of midline shift induced by the presence of compressive pneumocephalus.

CONCLUSIONS:

Systematic post-operative CT scan after unilateral CSDH evacuation could predict hematoma recurrence. We therefore considered it as recommended, to adapt the clinical and radiological follow-up of CSDH patients.

KEYWORDS:

Chronic subdural hematoma; Pneumocephalus; Recurrence; X-ray computed tomography

PMID:
27147520
DOI:
10.1007/s00701-016-2820-6
[Indexed for MEDLINE]

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