Clinical Manifestations of Chronic Subdural Hematoma according to Density on Computed Tomography

, Hyung Sug Oh; , Tae Wan Kim; , Han San Oh; , Kwan Ho Park

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2016;12(2):237-241.
Published online September 30, 2016.

Clinical Manifestations of Chronic Subdural Hematoma according to Density on Computed Tomography

Hyung Sug Oh , Tae Wan Kim , Han San Oh , Kwan Ho Park

Department of Neurosurgery, VHS Medical Center, Seoul, Korea

만성 경막하 혈종의 음영에 따른 임상 양상

오형석·김태완·오한산·박관호

중앙보훈병원 신경외과

Abstract

Objective
Chronic subdural hematoma (CSDH) is relatively common and easily diagnosed. Magnetic resonance imaging is currently recommended for diagnosis of CSDH, especially bilateral or multilayered hematoma, and for differential diagnosis between empyema, hygroma and hematoma. However, computed tomography (CT) remains an important diagnostic tool for CSH. The purpose of this study was to evaluate clinical manifestations of CSDH according to hematoma density on CT.
Methods
From January 2010 to December 2012, we selected 92 patients with CSDH who underwent burr hole trephination and hematoma drainage. We divided the patients into three groups; hypodense, isodense, and mixed hematoma, and subdivided mixed hematoma into separated and scattered types. Age, previous trauma history, laterality of hematoma, medication history (antiplatelet agent, anticoagulant), and recurrence were evaluated retrospectively.
Results
Patients who had taken antiplatelet agents and/or anticoagulants more commonly showed mixed density hematoma, with statistical significance (p=0.019). A high recurrence rate was associated with mixed density hematoma, with statistical significance (p=0.043). The scattered type recurred more often than the separated type, but this was not statistically significant (25.0% vs. 18.2%, p=0.649).
Conclusion
Patients with mixed density hematoma, especially the scattered type, had high recurrence rates after surgery. More careful follow-up of those cases may be needed.

Key Words: Chronic subdural hematoma, Recurrence, Computed tomography