Is systematic post-operative CT scan indicated after chronic subdural hematoma surgery? A case-control study

Acta Neurochir (Wien). 2016 Jul;158(7):1241-6. doi: 10.1007/s00701-016-2820-6. Epub 2016 May 5.


Background and aims: The aim of the present study was to evaluate the interest of systematic post-operative CT scan after unilateral chronic subdural hematoma (CSDH) evacuation. To achieve this goal, we chose to evaluate the ability of post-operative CT scan to predict the most frequent complication of CSDH: hematoma recurrence.

Methods: We performed a retrospective case-control study. Cases were defined as patients who had CSDH recurrence; controls were those who did not. We first studied clinical data and pre-operative CT scan data. We then studied post-operative CT scan data: hematoma thickness and its decrease, persistence of midline shift, its value and its decrease, and presence of compressive pneumocephalus.

Results: Among 654 patients, 15 were defined as cases, and were matched with 30 non-recurrent patients defined as controls. Regarding systematic post-operative CT scan findings, unilateral CSDH recurrence was clearly associated with the persistence of midline shift induced by the presence of compressive pneumocephalus.

Conclusions: Systematic post-operative CT scan after unilateral CSDH evacuation could predict hematoma recurrence. We therefore considered it as recommended, to adapt the clinical and radiological follow-up of CSDH patients.

Keywords: Chronic subdural hematoma; Pneumocephalus; Recurrence; X-ray computed tomography.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Hematoma, Subdural, Chronic / diagnostic imaging*
  • Hematoma, Subdural, Chronic / surgery
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging*
  • Tomography Scanners, X-Ray Computed
  • Tomography, X-Ray Computed*