Efficacy of different surgical methods and risk factors of recurrence for septated chronic subdural hematoma

Abstract

Objective To compare the efficacy of septated chronic subdural hematoma by small bone window craniotomy with or without neuroendoscopy, and to investigate risk factors of recurrence. Methods The clinical data of 73 patients diagnosed as septated chronic subdural hematoma in our department from March 2015 to September 2020 were collected and retrospectively analyzed. According to different surgical methods, the patients were divided into endoscopic group (n=32, small bone window craniotomy with aid of neuroendoscopy) and general group (n=41, small bone window craniotomy without neuroendoscopy). Clinical features, efficacy of different surgical methods, and risk factors for recurrence were analyzed. Results There were no notable differences in preoperative clinical features, postoperative complications, improvement of midline shift, postoperative modified Rankin scale (MRS) score, recurrence rate and mortality between the 2 groups. But statistical difference was seen in the operative time between them (P < 0.01). Binary logistic regression analysis indicated that preoperative anticoagulant treatment was a risk factor for postoperative recurrence (P < 0.05). Conclusion Neuroendoscopy did not improve the operative effectiveness of septated chronic subdural hematoma when compared with small bone window craniotomy. Preoperative anticoagulant may be a risk factor for its recurrence.

Keywords

• septated chronic subdural hematoma
• neuroendoscopy
• surgerical treatment
• risk factors
• small bone window craniotomy