Relationship between Bilateral Chronic Subdural Hematomas and Postoperative Recurrence

Objective:  The association between bilateral chronic subdural hematomas and postoperative recurrence remains controversial as conflicting evidence regarding this association exists in the literature. We carried out the present study to assess whether bilateral chronic subdural hematomas are associated with increased postoperative recurrence compared to unilateral chronic subdural hematomas after burrhole drainage. Materials & Methods:  We retrospectively studied the data of all the patients operated on in our department for chronic subdural hematoma evacuation through burrhole drainage and then included the data of sixty-three patients in our study. For the sake of uniformity, only patients without postoperative drainage were included in the study. The patients operated on for unilateral and bilateral chronic subdural hematomas were then compared with each other for their association with postoperative recurrence. Results:  Forty-five patients in our study had been operated on for a unilateral chronic subdural hematoma. Eighteen patients had been operated for bilateral chronic subdural hematomas. Of the forty-five patients who operated for unilateral chronic subdural hematomas, eight (17.8%) had a recurrence. Twelve (66.7%) of the eighteen patients operated for bilateral chronic subdural hematoma had a recurrence. This difference in recurrence between the unilateral and bilateral chronic subdural hematomas was found to be very significant (p = 0.0002). Conclusion:  We conclude that a bilateral chronic subdural hematoma is associated with significantly increased postoperative recurrence compared to a unilateral chronic subdural hematoma following burrhole drainage. Keywords:  Bilateral chronic subdural hematoma, unilateral chronic subdural hematoma, burrhole drainage, recurrence.