AbstractIntroduction: Chronic Subdural Haematoma (CSDH) is commonly seen in day to day Neurosurgical practice. The incidence of re-operation remains high.
Objective: The optimal surgical approach to reduce the re-operation rate has not been identified. The aim of this study is to evaluate the prognostic value of clinical & radiological parameters to predict the re-operation.
Methodology: A retrospective review of about 320 patients of Chronic Subdural Haematomas, who got admitted (May 2015 to May 2018) in the “Institute of Neurosurgery, Madras Medical College, Chennai was performed. Clinical and radiographic factors were analysed using Uni & Multi variate analyses.
Results: Various significant predictive factors like anticoagulant use, male sex, greater midline shift, presence of loculations/membranes, intraoperative saline irrigation etc. were analysed. The results showed that 0% ( no reduction), 50% and 100% haematoma maximum thickness change were associated with a 41%,6% and <1% rate of re-operation.
Conclusions: Among many factors, anticoagulant use, hematoma loculation & the amount of hematoma evacuation on first POD were the strongest predictors.