P.119 Clinical outcome and recurrence rate of chronic subdural hematoma after surgical drainage: a retrospective study

Abstract

Background: Chronic subdural hematoma (CSDH) is of the most encountered neurosurgical cases, predominantly in older individuals. Surgical drainage remains the mainstay, yet is challenged by variable recurrence rates. Less invasive methods of embolization of the middle meningeal artery (EMMA) could reduce the recurrence rates. Before adopting a newer treatment (EMMA), it is prudent to establish the outcomes from surgical drainage. The purpose of this study is to assess the clinical outcome and recurrence risk in surgically treated CSDH patients. Methods: A retrospective search of our surgical database was done to identify CSDH patients undergoing surgical drainage in 2019-2020. Demographic and clinical details were collected through chart review and a qualitative statistical analysis was performed. Results: A total of 136 patients (mean age-68 years; range-21-100 years; Male-105) with CSDH underwent surgical drainage with repeat surgery in 11.8%(n=16). Periprocedural mortality and morbidity were 8.8%(n=12) and 20.6%(n=28), respectively. No radiological follow-up was seen in 30(22%) of patients. Of those with follow-up, recurrence was seen in 21.7%(n=23). Mean hospital stay was 9.64 days. Conclusions: Our retrospective study showed periprocedural morbidity (20.6%) and mortality (8.8%) with a 21.7% risk of recurrence. This is likely due to older patients but is in keeping with what is reported in the literature.