Abstract

Subdural hematomas commonly recur after surgical evacuation, at a rate of 2% to 37%. Risk factors for recurrence can be patient related, radiologic, or surgical. Patient-related risk factors include alcoholism, seizure disorders, coagulopathy, and history of ventriculoperitoneal shunt. Radiologic factors include poor brain reexpansion postoperatively, significant subdural air, greater midline shift, heterogeneous hematomas (layered or multi-loculated), and higher-density hematomas. Surgical factors include lack of or poor postoperative drainage. Most recurrent hematomas are managed successfully with burr hole craniostomies with postoperative closed-system drainage. Refractory hematomas may be managed with a variety of techniques, including craniotomy or subdural-peritoneal shunt placement.

Original languageEnglish (US)
Pages (from-to)279-286
Number of pages8
JournalNeurosurgery clinics of North America
Volume28
Issue number2
DOIs
StatePublished - Apr 2017

Keywords

  • Craniotomy
  • Hematoma, Subdural, Chronic
  • Humans
  • Postoperative Care
  • Postoperative Complications
  • Recurrence
  • Risk Factors
  • Secondary Prevention
  • Treatment Outcome
  • Journal Article
  • Review

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