ArticleAmerican journal of translational research2026
Risk factors for subdural hematoma in spontaneous intracranial hypotension are male sex, longer disease duration, and repeated epidural blood patches.
Article in American journal of translational research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the clinical characteristics and risk factors for subdural hematoma (SDH) in patients with spontaneous intracranial hypotension (SIH), with a focus on male sex, disease duration, and repeated epidural blood patch (EBP) procedures.
methodsThis retrospective cohort study included 579 consecutive SIH patients admitted between June 2019 and November 2025. Patients were divided into an SDH group (n = 101) and a non-SDH group (n = 478) based on brain imaging. Demographic data, clinical characteristics, laboratory parameters, brain imaging features, spinal imaging findings, and treatment details were collected.
resultsSDH patients were more frequently male (60.4% vs. 32.4%, P < 0.001), older (45.4 ± 12.7 vs. 41.6 ± 9.5 years, P = 0.005), and had longer disease duration (52.3 ± 23.1 vs. 39.2 ± 18.3 days, P < 0.001). They exhibited higher systolic blood pressure (122.7 ± 16.4 vs. 118.8 ± 16.4 mmHg, P = 0.033) and more neurological deficits (30.7% vs. 10.3%, P < 0.001). Brain imaging showed increased frequency of brain sagging (55.5% vs. 40.8%, P = 0.007), dural enhancement (80.2% vs. 64.4%, P = 0.002), venous distension (56.4% vs. 39.1%, P = 0.001), and subdural effusion (36.6% vs. 25.5%, P = 0.023) in the SDH group. Spinal imaging revealed more identifiable leaks (93.1% vs. 77.8%, P < 0.001). The SDH group underwent more EBP procedures (1.43 ± 0.64 vs. 1.23 ± 0.51, P = 0.004). Multivariate analysis identified male sex, age, disease duration, dural enhancement, and number of EBP procedures as independent SDH risk factors (P < 0.05).
conclusionMale sex, longer disease duration, dural enhancement on brain imaging, and repeated EBP procedures were independent risk factors for SDH in patients with SIH, highlighting a need for close monitoring in high-risk individuals.
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