Torihashi Kouichi, Sadamasa Nobutake, Yoshida Kazumichi, Narumi Osamu, Chin Masaki, Yamagata Sen
Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki City, Okayama, Japan.
Neurosurgery. 2008 Dec;63(6):1125-9; discussion 1129. doi: 10.1227/01.NEU.0000335782.60059.17.
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.
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.
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).
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.
慢性硬膜下血肿（CSDH）是一种常见的颅内出血形式，复发率较高。我们着重于确定与CSDH复发相关的独立预测因素。
我们回顾性分析了343例连续的CSDH手术病例。进行单因素和多因素分析，以描述CSDH复发与性别、年龄、高血压、糖尿病、心脏病、脑血管疾病、心房颤动、抗血小板或抗凝治疗以及双侧CSDH等因素之间的关系。
61例患者出现CSDH复发。单因素和多因素分析发现，双侧CSDH是CSDH复发的独立危险因素。虽然抗血小板和抗凝治疗对CSDH复发无显著影响，但接受抗血小板和/或抗凝治疗的患者受伤至首次手术的时间间隔比未接受治疗的患者短（29.9天对44.2天）。
双侧CSDH是CSDH复发的独立预测因素。抗血小板或抗凝药物可能促进CSDH的生长。这些结果可能有助于识别CSDH复发的高危患者。
