Journal of Korean Society of Geriatric Neurosurgery 2016;12(2):232-236.
Published online September 30, 2016.
Relationship Between Chronic Subdural Hematoma and the Development or Progression of Brain Atrophy
Han San Oh , Tae Wan Kim , Hyung Sug Oh , Kwan Ho Park
Department of Neurosurgery, VHS Medical Center, Seoul, Korea
만성 경막하 혈종과 뇌 위축의 발생, 진행과의 관계
오한산·김태완·오형석·박관호
중앙보훈병원 신경외과
Abstract
Objective
Brain atrophy may occur with aging, or traumatic brain injury, or because of diseases such as multiple sclerosis, Alzheimer’s disease, dementia, or infection. Brain atrophy can induce cognitive decline and lead to memory impairment. The purpose of this study was to evaluate the relationship between chronic subdural hematoma (CSDH) and the development or progression of brain atrophy after surgery.
Methods
A retrospective study was performed on 33 patients with CSDH from January 2010 to December 2012. All patients had undergone surgery with burr hole trephination, hematoma drainage, and pre- and post-operative radiologic brain evaluation, with at least 12-month follow-up. We excluded patients who did not have a pre-operative brain evaluation with which to compare postoperative changes. We measured brain atrophy using the Pasquier cortical atrophy scale. We divided the patients into two groups: the brain atrophy group (n=9) and non-atrophy group (n=24).
Results
The mean age and follow-up period of patients were 76.7 years and 23.9 months, respectively. Development or progression of brain atrophy occurred in nine patients (27.3%). Development or progression of brain atrophy occurred more commonly in cases that the patients was older than 75 years, presented with CSDH with a history of trauma, or presented recurrence of CSDH; however, the differences were not statistically significant.
Conclusion
We suggest that CSDH may possibly induce or exacerbate brain atrophy. Greater caution and longer follow-up may be needed after CSDH surgery in cases with an elderly patient, history of trauma prior to CSDH, and recurrence of CSDH.
Key Words: Subdural hematoma, Brain atrophy, Elderly, Trauma, Recurrence


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