Bilateral chronic subdural haematoma: Analysis of a series of 190 patients

作者：Gelabert Gonzalez Miguel^*; Aran Echabe Eduardo; Javier Bandin Dieguez Francisco; Maria Santin Amo Jose; Serramito Garcia Ramon; Prieto Gonzalez Angel; Garcia Allut Alfredo

来源：Neurocirugia, 2016, 27(3): 103-111.

DOI：10.1016/j.neucir.2015.07.002

• Bilateral
• Markwalder scale
• Chronic subdural haematoma
• Recurrence
• Computed tomography
• Unilateral

Objective: The aim of this study is to analyse the clinical findings and surgical results in a series of patients with bilateral chronic subdural haematoma (BCSDH), and compare the results with a series of patients treated for unilateral chronic subdural haematoma (UCSDH).
Patients and methods: A retrospective study was performed on 1523 patients diagnosed and surgically treated for chronic subdural haematoma over a period of 30 years. Patients were divided into 2 groups: The study group consisting of 190 patients operated on for a BCSDH and the control group consisting of patients operated on for an UCSDH (1333 cases).
Results: The patient series included 126 males (66.3%) and 64 females (33.7%), with a mean age at diagnosis of 74.8 10.2. The control group consisted of 870 males (65.2%) and 463 women (34.8%), with a mean age of 73.2 +/- 12.1. The most common presenting symptoms was cognitive impairment in 63 patients (33.2%) with BCSDH and 416 (29.5%) with UCSDH. Recurrence rates were 9.4% (18 patients) and 5.7% (77 patients) in unilateral and bilateral haematomas, respectively. The mortality was 10 patients (5.2%) with BCSDH and 55(4%) with UCSDH. Factors significantly related to recurrence in the univariate analysis were being male (P=.040), anticoagulant/antiplatelet therapy (P=.032), and poor neurological status at admission (P=.039).
Conclusions: This study indicates that BCSDH is more frequent in males, and the most common presentation is headache. The most important factors influencing. recurrences are being male, intake of anticoagulant-antiaggregant drugs, and worse clinical status at admission.

• 出版日期2016-6