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Abstract

Background Pneumocephalus is a prevalent radiographic finding following drainage of chronic subdural hematoma (CSDH). Large volume pneumocephalus can be an agonizing load for patients and treating team. Methods A retrospective study conducted on 72 adults who underwent surgical evacuation for CSDH from March 2021 to March 2023. Preoperative data and postoperative results were compared between patients with and those without postoperative pneumocephalus. Results Postoperatively, 35 patients (48.6%) developed pneumocephalus; it was of simple type in 30 patients and tension pneumocephalus in 5 patients. Factors significantly correlated with postoperative pneumocephalus included: age above 60 (P = 0.018); duration of symptoms > 15 days (P = 0.008); bilateral CSDH (P = 0.019); midline shift (MLS) > 5 mm (P = 0.035); operative time > 60 minutes; (P = 0.016) and bilateral surgical procedures (P = 0.003). Development of pneumocephalus was significantly associated with postoperative seizures and prolonged hospital stay (P = 0.032 and 0.004 respectively). No significant difference was reported between patients with or without pneumocephalus regarding discharge outcome (P = 0.477). During follow up, 7 cases developed CSDH recurrence including 5 cases who had pneumocephalus but the difference was not statistically significant (P = 0.204). Conclusions Incidence of pneumocephalus after drainage of CSDH can be higher among patients with: age above 60 years; symptoms duration > 15 days; MLS > 5 mm; bilateral CSDH; bilateral surgical procedures and operative time > 60 minutes. Postoperative pneumocephalus might increase the risk for postoperative seizures, prolong hospital stay and raise the recurrence rate.

Subject Area

Neurosurgery

Article Type

Original Study

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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