Prediction of Postoperative Drainage Volume and Brain Expansion of Chronic Subdural Hematoma; Supplement Study

초록

PURPOSE : Chronic subdural hematoma(CSDH) is relatively common disease, however it is a few studies to predict the postoperative drainage volume of CSDH and the relation between the brain expansion and the postoperative drainage volume. The authors already report the factor associated with postoperative drainage volume after the operation of CSDH, we have investigated with more added patient data. MATERIALS AND METHODS : Seventy seven patients with CSDH, who were operated burr hole drainage from Janurary, 2002 to December, 2008 was investigated retrospectively multiple factors associated with CSDH including the hemorrhage density and measured the parameters about the brain compliance on computed tomography(CT) scans. Parameter A means the distance between both inner skull table at the level of frontal horn of lateral ventricle, and parameter B means the distance between the most medial side of caudate nucleus head and the ipsilateral inner skull table at the same level of the parameter A. We estimated the brain expansion using the degree of frontal horn compression and midline shifting by the B/A ratios and made an analysis for the relation with the postoperative drainage volume statistically. Preoperative hematoma volume was calculated with method which descripted by Sucu. RESULTS : The mean age was 67.8 years, estimated volume with CT scans was 139 ml, mean real drainage volume was 261 ml, and mean B/A ratio was 0.53. The postoperative drainage volume of CSDH was significant correlated with the density of CSDH in brain CT, and also the postoperative drainage volume was decreased as the B/A ratio was increased. CONCLUSION : The postoperative drainage volume after operation of CSDH was affected by brain expansion. Postoperative drainage volume of CSDH can be predicted with the density types of CSDH and the degree of frontal horn compression