ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Postoperative pneumocephalus as a predictor of chronic subdural hematoma recurrence: a retrospective cohort analysis.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Postoperative Density of Residual Hematoma Is a Predictor of Chronic Subdural Hematoma Recurrence-A Single-Center Retrospective Study.Neurology international · 2026Article
- Hematoma Capsule Spanning the Sylvian Fissure and Non-Blocking the Middle Meningeal Artery During Surgery Are Associated With Postoperative Recurrence of Chronic Subdural Hematoma.International journal of general medicine · 2026Article
- Endoscopic-Assisted evacuation vs. burr-hole drainage for chronic subdural hematoma: a retrospective comparative study.Frontiers in surgery · 2026Article
- Standardized single-burr-hole aspiration-irrigation with drainage is associated with lower early recurrence in chronic subdural hematoma.Frontiers in neurologyArticle
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Abstract
backgroundChronic subdural hematoma (CSDH) is a common neurosurgical condition, especially in the elderly, which is usually diagnosed by computed tomography (CT) scan and often treated surgically. After surgery patients shows favourable outcomes with improvement in symptomatology. Despite the availability of various surgical techniques, complications continue to occur frequently due to the advanced age of patients and underlying medical conditions. Burr-hole craniotomy followed by placement a closed-system drainage is widely considered the best treatment for CSDH, although technical challenges and a high recurrence rate remain. Postoperative pneumocephalus is a potential risk factor for recurrence. While the majority of patients recover well after surgery, recurrence or persistence of CSDH occurs in 0.35-33% of cases, sometimes necessitating additional surgeries.
methodThis retrospective study comprehensively evaluates the clinical data of 229 patients diagnosed with chronic subdural hematoma (CSDH) who underwent surgical intervention, specifically burr-hole craniotomy with drainage between 2016 and 2021. The primary objective is to measure the prognostic significance of postoperative pneumocephalus as a predictor of recurrence of CSDH. Furthermore, the obtained univariate and multivariate regression analyses examines various patient-specific factors, including age, gender, location of CSDH (unilateral or bilateral), anticoagulation therapy status, neurosurgical follow-up outcomes, hospital readmission rates, and the incidence of repeat surgical procedures.
resultAmong the analysed characteristics, postoperative pneumocephalus exceeding a specified volumetric threshold emerges as the only significant predictor of CSDH recurrence. This recurrence of CSDH is additionally associated with a substantial prolongation of the patient's hospitalization, highlighting its clinical and logistical significance.
conclusionA postoperative pneumocephalus is nearly unavoidable; however, optimizing surgical technique to minimize its volume below 5.2 cm
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