Frontiers in Neurology (Sep 2022)

Recurrence of chronic subdural hematoma due to low-grade infection

  • Daniel Dubinski,
  • Sae-Yeon Won,
  • Svorad Trnovec,
  • Kseniya Gounko,
  • Peter Baumgarten,
  • Philipp Warnke,
  • Daniel Cantré,
  • Bedjan Behmanesh,
  • Joshua D. Bernstock,
  • Thomas M. Freiman,
  • Florian Gessler,
  • Steffen Sola

DOI
https://doi.org/10.3389/fneur.2022.1012255
Journal volume & issue
Vol. 13

Abstract

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Despite the high incidence and multitudes of operative techniques, the risk factors for chronic subdural hematoma (CSDH) recurrence are still under debate and a universal consensus on the pathophysiology is lacking. We hypothesized that clinically inapparent, a low-grade infection could be responsible for CSDH recurrence. This investigation is a single-center prospective observational study including patients with recurrent CSDH. In total, 44 patients with CSDH recurrence received an intraoperative swab-based microbiological test. The intraoperative swab revealed an inapparent low-grade hematoma infection in 29% of the recurrent CSDH cases. The majority (69%) of the identified germs belonged to the staphylococcus genus. We therefore, propose a novel potential pathophysiology for CSDH recurrence.

Keywords