Factors influencing the results of surgical therapy of non-acute subdural haematomas

Purpose To identify predictive factors with an impact on the outcome of surgical treatment of non-acute subdural haematomas (NASH). Methods One hundred eleven patients who underwent an evacuation of 132 NASH by means of burr hole or craniotomy from January 2014 to December 2018 were retrospectively analyzed. We evaluated the impact of factors that could possibly predict the result of surgical treatment. The assessment was focused on the impact of factors, such as age, gender, pre-operative clinical symptoms, timing and extent of surgical procedure, intake of anticoagulants and antiplatelet drugs, morphological type, recurrence, side localization or bilateral occurrence of NASH. Patients’ functional outcome was quantified using the Glasgow Outcome Score (GOS) with a follow-up period of 3 months. Results Morphological type of NASH did not have any significant impact on the final GOS. The risk factors associated with less favorable GOS included preoperative intake of anticoagulants and preoperative finding of phatic disorder, quantitative disorder of consciousness and disorientation. Preoperative intake of antiplatelet drugs or anticoagulants and craniotomy were risk factors for postoperative development of a surgically significant acute extracerebral haematoma. The complications occurred significantly more often after a craniotomy when compared to the burr hole evacuation ( p = 0.0163), but the incidence of recurrence of NASH was significantly lower ( p = 0.0439). Conclusion The risk factors for the surgical treatment of NASH included preoperative intake of antithrombotic drugs and evacuation of NASH through craniotomy. Craniotomy resulted in a significantly lower incidence of recurrence.