Surgical management of the patients with chronic subdural haematoma and contralateral subdural effusion: Operation or no-operation?

OBJECTIVE

Patients with chronic subdural haematoma and contralateral subdural effusion are rare after head injury. Surgery might reduce clinical progression of subdural effusion, but is not used routinely. This study aimed to investigate the effect of surgery on subdural effusion and clinical outcome.

METHODS

A retrospective study was performed, comparing operation and non-operation in the patients with chronic subdural haematoma and contralateral subdural effusion, in a series of 47 patients divided into two groups. The operation group of 21 patients underwent bilateral surgery. The non-operation group of 26 patients underwent surgery on the side with chronic subdural haematoma. Neurological status was assessed by the Glasgow Coma score and Modified Rankin Scale score on admission and at follow-up. All cases underwent pre- and post-operative computed tomography scans.

RESULTS

Pre-operative clinical and radiological data were similar in the two groups. The rate of subdural effusion progression was significantly lower in the operation group than in the non-operation group (p < 0.05). Thirteen cases (50%) in the non-operation group and three cases (14.3%) in the operation group had progression of subdural effusion to chronic subdural haematoma (p < 0.05). Chronic subdural haematoma recurrence rate, mortality and neurological recovery were similar, with no significant difference between groups.

CONCLUSIONS

The patients benefitted from surgery for subdural effusion when they had chronic subdural haematoma and contralateral subdural effusion.