| Analysis of risk factors for subdural hydroma and chronic subdural hematoma after surgical clipping of ruptured intracranial aneurysms |
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| Citation of this paper:.Analysis of risk factors for subdural hydroma and chronic subdural hematoma after surgical clipping of ruptured intracranial aneurysms[J].Chinese Journal of Clinical Medicine,2018,25(6):924-928 |
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| Abstract:Objective：To investigate the risk factors for the postoperative occurrence of subdural complications, such as a subdural hydroma and resultant chronic subdural hematoma (CSDH), following surgical clipping of ruptured aneurysms. Methods：The data of 57 consecutive patients who underwent aneurysm clipping for ruptured aneurysms in the anterior cerebral circulation between January, 2010 and July, 2018 were reviewed retrospectively. The subdural hydromas and CSDH were identified based on dynamic CT scans after surgery, and their volume was measured using imaging software. The incidence of the postoperative subdural complications were calculated. The follow-up results of the subdural complications were also investigated. Uni- and multivariate logistic regression analysis were performed to evaluate the risk factors for the postoperative subdural complications. Results：The incidence of subdural hydroma and resultant CSDH was 21.1% (12/57) and 12.3% (7/57), respectively. Subdural hydroma resolved spontaneously in 5 cases and converted to a CSDH in 7 cases during the mean follow-up period of 61.1±30.3 months. The former was significantly less in volume than the latter (［26.4±14.6］ mL vs ［80.0±52.3］ mL, P=0.002). The results of univariate analysis showed that male sex, advanced age (>60 years old), aneurysm distribution (middle cerebral artery aneurysm and multiple concomitant aneurysms), the degree of brain atrophy, and history of lumbar cistern drainage were all significant risk factors for the postoperative subdural hydroma. A multivariate analysis indicated that male sex, advanced age (>60 years old), middle cerebral artery aneurysm and multiple concomitant aneurysms were independent risk factors for the postoperative subdural hydroma, and the male sex and advanced age were independent risk factors for subdural hydroma that develops into CSDH. Conclusions：Advanced age(>60 years), male sex, middle cerebral artery aneurysm and multiple concomitant aneurysms might be the independent risk factors for the subdural hydroma and CSDH after surgical clipping of ruptured intracranial aneurysms. |
| keywords:subdural hydroma chronic subdural hematoma intracranial aneurysms postoperative complications risk factors |
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