Independent Predictors for Recurrence of Chronic Subdural Hematoma: A Review of 343 Consecutive Surgical Cases

Abstract OBJECTIVE Chronic subdural hematoma (CSDH) is a common form of intracranial hemorrhage with a substantial recurrence rate. We focused on determining independent predictors associated with the recurrence of CSDH. METHODS We retrospectively reviewed 343 consecutive surgical cases of CSDH. Univariate and multivariate analyses were performed to describe the relationships between recurrence of CSDH and factors such as sex, age, hypertension, diabetes mellitus, heart disease, cerebrovascular disease, atrial fibrillation, antiplatelet or anticoagulant therapy, and bilateral CSDH. RESULTS Sixty-one patients experienced a recurrence of CSDH. Univariate and multivariate analyses found that bilateral CSDH was an independent risk factor for the recurrence of CSDH. Although antiplatelet and anticoagulant therapy had no significant effect on recurrence of CSDH, the time interval between the injury and the first operation for patients with antiplatelet and/or anticoagulant therapy was shorter than that for patients without it (29.9 versus 44.2 days). CONCLUSION Bilateral CSDH was an independent predictor for the recurrence of CSDH. Antiplatelet or anticoagulant drugs might facilitate the growth of CSDH. These results may help to identify patients at high risk for the recurrence of CSDH.