Factors Associated with the Recurrence of a Surgically Evacuated Intracranial Chronic Subdural Hematoma using Burr-hole Irrigation: A Cross-sectional Retrospective Single-center Study

Ali Adnan Dolachee; Ghazwan Alwan Lafta; Hayder Sbahi; Laith Thamer Al-Ameri

doi:10.54133/ajms.v11i1.3182

Authors

Ali Adnan Dolachee Department of Surgery, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0000-0001-9048-6099
Ghazwan Alwan Lafta Department of Surgery, College of Medicine, University of Al-Ameed, Kerbala, Iraq https://orcid.org/0000-0003-0770-8469
Hayder Sbahi Department of Surgery, Imam Al-Hasan Hospital, Kerbala, Iraq
Laith Thamer Al-Ameri Department of Surgery, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0000-0002-5863-1564

DOI:

https://doi.org/10.54133/ajms.v11i1.3182

Keywords:

Burr-hole evacuation, Chronic subdural hematoma, Head trauma , Recurrent hematoma

Abstract

Background: Chronic subdural hematoma (CSDH) is a common neurosurgical entity characterized by the accumulation of blood in the subdural space. Despite proper surgical management, recurrence of CSDH remains a clinically relevant problem that may necessitate reoperation and prolong morbidity. Objective: To evaluate the factors affecting the recurrence of chronic subdural hematoma after surgical evacuation. Methods: A retrospective cross-sectional study of 50 patients with CSDH evaluated at the emergency room of Neurosurgical Teaching Hospital from October 2024 through September 2025. All the patients were fully examined, managed, and discharged home after 7 days of surgical treatment and followed up for 3 months. Results: The study included 50 patients; 44 (88%) were male, and 6 (12%) were female. Age ranged from 23 to 87 years, with a mean of 69.55±18.4 years for both genders, peaking in the seventh decade. CSDH was on the right side in 30%, the left side in 44%, and bilateral in 26% (13 patients). The mean thickness was 2.4±0.46 cm, ranging from 0.8 to 3.4 cm. Among the 50 patients, 28 had brain atrophy on the CT scan. Recurrence occurred in 10 patients (20% of cases). Conclusions: Factors affecting hematoma recurrence include patient factors (age, bleeding profile, associated diseases, and antiplatelet medications) and radiological factors (hematoma location and thickness, midline shift, and presence of a visible membrane on brain CT).

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