Risk Factors of Chronic Subdural Hematoma after Clipping of Intracranial Aneurysm

, Seng-Won Kim; , Hak-Ki Choi; , Jae-Hyon Shim; , Kil-Sung Chae; , Seung-Jin Rho; , Hwa-Seung Park

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2015;11(1):13-18.
Published online June 30, 2015.

Risk Factors of Chronic Subdural Hematoma after Clipping of Intracranial Aneurysm

Seng-Won Kim , Hak-Ki Choi , Jae-Hyon Shim , Kil-Sung Chae , Seung-Jin Rho , Hwa-Seung Park

Department of Neurosurgery, Bongseng Memorial Hospital, Busan, Korea

뇌동맥류의 수술적 치료 이후 발생한 만성 경막하 혈종의 위험인자에 대한 연구

김성원·최학기·심재현·채길성·노승진·박화성

김원묵기념 봉생병원 신경외과

Abstract

Objective
The purpose of this study is to identify the risk factors of chronic subdural hematoma (CSDH) after clipping of intracranial aneurysm.
Methods
A total of 445 patients with intracranial aneurysm were received aneurysmal clipping from January 2007 to December 2014, and all of the patients had the aneurysm of anterior circulation aneurysm. We reviewed characteristics and risk factors of CSDH requiring surgery after aneurysmal clipping. Brain computed tomography (CT), demographic variables, clinical outcomes were retrospectively analyzed.
Results
Fourteen patients (3.1%) developed CSDH after the clipping, which required drainage. There was no significant difference between ruptured and unruptured aneurysm. On univariate statistic analysis, risk factors of CSDH were correlated with advanced age (≥70 years, p=0.001), male gender (p=0.007), an increase in postoperative subdural fluid collection (SFC) during 1^st week (p=0.000). Complex proximal sylvian cistern variation in preoperative CT scan (p=0.001) was significant risk factor for CSDH (p=0.001).
Conclusion
The same as previous other study, this study showed that an elderly male patients (≥70 years of age) and increase of postoperative SFC during 1st week in CT scan carry higher risk for CSDH. We suggest that complex proximal sylvian cistern type can be a factor in predicting CSDH after clipping.

Key Words: Intracranial aneurysmㆍSubdural hematomaㆍChronicㆍRisk factorsㆍSubdural effusion