POSTOPERATIVE CHRONIC SUBDURAL HEMATOMA FOLLOWING CLIPPING SURGERY

概要

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Object: Chronic subdural hematoma (CSDH) after aneurysm clipping is a rare complication, but the risk factors are not known in detail. We retrospectively reviewed cases requiring surgery for CSDH.Methods: Between January 2000 and December 2006, 461 consecutive patients in the National Cardiovascular Center underwent clipping (or coating) surgery for unruptured aneurysm of anterior circulation. We reviewed the incidence and risk factors of the development of CSDH after aneurysmal clipping, and focused on subdural fluid collection (SFC) and increase, reviewing CT scans after clipping over the last two years.Results: 13(2.8%) developed postoperative CSDH which required surgery. Risk factors of postoperative CSDH included advanced age (p=0.002), and male gender (p=0.02). We could find no significant difference between aneurysmal sites and postoperative CSDH. An increase of SFC over 1 week postoperatively was also shown to be a significant risk factor for CSDH (p=0.001).Conclusion: This study showed advanced age and male gender were significant factors in the formation of postoperative CSDH. We suggest that an increase of SFC over 1 week postoperatively can be a factor predicting CSDH after clipping.
2010-05-06