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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(01): 122-125
DOI: 10.4103/ajns.AJNS_298_17
Original Article

Variation of ventricular size after surgical treatment of chronic subdural hematoma

Abad El Asri
1   Department of Neurosurgery, Military Hospital, Rabat
2   Department of Neurosurgery, University Hospital Hassan II, Fes
,
Mohammed Benzagmout
2   Department of Neurosurgery, University Hospital Hassan II, Fes
,
Khalid Chakour
2   Department of Neurosurgery, University Hospital Hassan II, Fes
,
Mohamed Chaoui
2   Department of Neurosurgery, University Hospital Hassan II, Fes
,
Jawad Laaguili
1   Department of Neurosurgery, Military Hospital, Rabat
,
Miloudi Gazzaz
1   Department of Neurosurgery, Military Hospital, Rabat
,
Hassan Baallal
1   Department of Neurosurgery, Military Hospital, Rabat
,
Brahim El Mostarchid
1   Department of Neurosurgery, Military Hospital, Rabat
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Background: Surgical removal is the treatment of choice for chronic subdural hematoma (CSDH). Despite clinical improvement after surgery, computed tomography (CT) scan control often showed residual collection, which may discuss the possibility of failed surgery. The aim of this study is the assessment of ventricular size before and after surgery and to study its relation with residual hematoma. Methods: In this prospective study (2013-2016), 63 patients who had burr-hole drainage of CSDH were sequentially allocated to either two groups; Group 1 with CT scan control under the 3rd day of surgery and Group 2 with delayed CT scan control (from 4th to 7th day). Linear measure of ventricular size was assessed by Evans' index. We reviewed and analyzed the data between both groups. Results: There were 33 patients in Group 1 and 30 patients in Group 2. Preoperatively, the average thickness of hematoma was 20.5 mm in Group 1 versus 19.9 mm in Group 2 (P = 0.67); the mean midline shift was 8.5 mm in each group; Evans' index was 26.7% in Group 1 and 27% in Group 2 (P = 0.7). Postoperatively, the mean thickness of the residual hematoma was 7.7 mm in Group 1 and 8.4 mm in Group 2 (P = 0.57); the mean midline shift was 3.3 mm in Group 1 and 1.9 mm in Group 2 (P = 0.08); Evan's index was 28.5% in Group 1 and 32.1% in Group 2 (P = 0.002). Conclusion: The adoption of Evans' index, for assessing the variation of ventricular size after surgery, by neurosurgeons appears to be a good and simple method for evaluation and following the success of surgical removal of CSDH, despite the observation of some residual collection in early CT scan control.

Key-words:

Chronic subdural hematoma - computed tomography scan control - Evans' index - ventricular seize

Financial support and sponsorship

Nil.




Publikationsverlauf

Artikel online veröffentlicht:
09. September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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