Chronic Subdural Hematoma Treated by Small or Large Craniotomy with Membranectomy as the Initial Treatment.
10.3340/jkns.2011.50.2.103
- Author:
Jae Hong KIM
1
;
Dong Soo KANG
;
Jung Hee KIM
;
Min Ho KONG
;
Kwan Young SONG
Author Information
1. Department of Neurosurgery, Seoul Medical Center, Seoul, Korea. kdsyjyw@hotmail.com
- Publication Type:Original Article
- Keywords:
Chronic subdural hematoma;
Small craniotomy;
Large craniotomy;
Reoperation
- MeSH:
Craniotomy;
Hematoma;
Hematoma, Subdural, Chronic;
Humans;
Length of Stay;
Magnetic Resonance Imaging;
Recurrence;
Reoperation;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
2011;50(2):103-108
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: There are few studies comparing small and large craniotomies for the initial treatment of chronic subdural hematoma (CSDH) which had non-liquefied hematoma, multilayer intrahematomal loculations, or organization/calcification on computed tomography and magnetic resonance imaging. These procedures were compared to determine which would produce superior postoperative results. METHODS: Between 2001 and 2009, 317 consecutive patients were surgically treated for CSDH at our institution. Of these, 16 patients underwent a small craniotomy with partial membranectomy and 42 patients underwent a large craniotomy with extended membranectomy as the initial treatment. A retrospective review was performed to compare the postoperative outcomes of these two techniques, focusing on improvement of neurological status, complications, reoperation rate, and days of post-operative hospitalization. RESULTS: The mean ages were 69.4+/-12.1 and 55.6+/-9.3 years in the small and large craniotomy groups, respectively. The recurrence of hematomas requiring reoperation occurred in 50% and 10% of the small and large craniotomy patients, respectively (p<0.001). There were no significant differences in postoperative neurological status, complications, or days of hospital stay between these two groups. CONCLUSION: Among the cases of CSDH initially requiring craniotomy, the large craniotomy with extended membranectomy technique reduced the reoperation rate, compared to that of the small craniotomy with partial membranectomy technique.
