Related factors for the development of subdural haematoma in patients with spontaneous intracranial hypotension

Abstract

Objective To investigate related factors for subdural haematoma (SDH) in patients with spontaneous intracranial hypotension (SIH), and to provide clinical evidence for the prevention and treatment of the disease. Methods The clinical and imaging data of 177 patients with SIH from Sir Run Run Shaw Hospital during April 2008 to May 2014 were retrospectively analyzed, 145 patients of whom were selected as study subjects and divided into SDH group and non-SDH (NSDH) group. And then the univariate analysis and further multiple Logistic regression analysis were performed to identify the potential risk factors, including gender, age, clinical course, blood pressure, cerebrospinal fluid pressure, lesions, for the development of SDH. Results In 29 of 145 patients with the development of SDH (20.0%), male patients accounted for the majority (62.1%, 18/29). The mean age was (44.72±11.03) years and the mean clinical course was (50.41±30.42) days in the SDH group, which were (39.96±9.35) years and (31.70±24.39) days in the NSDH group. The univariate analysis showed that advanced age, male gender and longer clinical course were associated with the development of SDH. However, multivariate analysis only included male (Exp(B)=3.636, 95% CI 1.559-8.482, P=0.003) and longer clinical course (Exp(B)=1.021, 95% CI 1.006-1.036, P=0.005). When the clinical course has been exceeded 18 days, the probability of the development of SDH was significantly higher, with the incidence of SDH increased to 24.3% (26/107), obviously higher than that in patients with clinical course ≤18 days (7.9%(3/38); χ2 =4.716, P=0.030). Conclusions The male gender and the longer clinical course were found to be the potential risk factors for the development of SDH. When the clinical course duration exceeds 18 days, there will be a greater potential for the development of SDH comparing with other factors. Key words: Intracranial hypotension; Haematoma, subdural; Risk factors; Clinical course