[Early results of surgical treatment of chronic subdural hematoma in CT images].

Since the introduction of CT it has become possible to trace the pattern of brain changes after removal of subdural haematoma. Postoperative studies show frequently presence of haematoma residues, and this is connected with the problem of deciding about establishing of indications to reoperation, especially difficult if the patient is in a good clinical condition. The clinical status was compared with CT findings preoperatively and postoperatively in 20 patients subjected to operations for chronic subdural haematomas. A statistically significant correlation was found between the size of the mass effect in CT before and after the operation and the severity of the clinical condition. Major mass effect with high-grade ventricular shifting is more frequently connected with partially haemolysed haematoma in CT. The thickness of subdural haematoma exceeding 20 mm correlated with severe clinical condition, and increased the probability of hemiparesis persistence after the operation. Finding of residual haematoma in CT imaging after the operation, especially when not associated with high-grade mass effect, and with good clinical condition should not be accepted as an indication to repeated operation. In the presented material out of 15 patients with good clinical condition 12 had CT evidence of residual haematoma, and only one had reoperation in view of persisting evident mass effect.