The Risk Factors of Subdural Hygroma after Decompressive Craniectomy.
10.13004/kjnt.2018.14.2.93
- Author:
Byeong Oh KIM
1
;
Jong Yeon KIM
;
Kum WHANG
;
Sung Min CHO
;
Ji Woong OH
;
Youn Moo KOO
;
Chul HU
;
Jin Soo PYEN
;
Jong Wook CHOI
Author Information
1. Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. nschoi@yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Decompressive craniectomy;
Subdural effusion;
Subarachnoid hemorrhage
- MeSH:
Brain Injuries;
Decompressive Craniectomy*;
Diagnosis;
Hematoma, Subdural;
Humans;
Length of Stay;
Odds Ratio;
Prognosis;
Retrospective Studies;
Risk Factors*;
Subarachnoid Hemorrhage;
Subdural Effusion*
- From:Korean Journal of Neurotrauma
2018;14(2):93-98
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Subdural effusion, also known as subdural hygroma (SDG), is a secondary complication that can occur after decompressive craniectomy (DC). However, the pathogenesis of SDG is not fully understood. It is unclear whether SDG occurrence is related to preoperative patient status or surgical technique. The purpose of this study is to identify risk factors for SDG after DC. METHODS: Fifty-nine patients who underwent DC from January 2016 to December 2016 at the same institution were analyzed. We retrospectively reviewed the clinical and radiological features of the patients. We divided the patients into two groups based on the occurrence of SDG after DC. The risk factors for SDG were analyzed. RESULTS: The overall SDG rate after DC was 39% (23 patients). A statistically significant association was observed between preoperative diagnosis, e.g., subdural hemorrhage (SDH; odds ratio [OR], 4.99; 95% confidence interval [CI], 1.36–18.34) or subarachnoid hemorrhage (SAH; OR, 4.18; 95% CI, 1.07–16.32), and the occurrence of SDG after DC. Traumatic brain injury (OR, 4.91; 95% CI, 1.35–17.91) and preoperative cortical opening (OR, 4.77; 95% CI, 1.39–16.32) were important risk factors for SDG. Several surgical techniques did not show a statistically significant association with SDG. The occurrence of SDG after DC was related to the length of hospital stay (p=0.012), but not to prognosis. CONCLUSION: After DC, SDG is not related to patients' prognosis but to the length of hospital stay. Therefore, it is necessary to study the occurrence of postoperative SDG by confirming the presence of preoperative SDH, SAH, and cortical opening.
