Published: 2021-12-28

Chronic subdural hematoma pressure measurement and its correlation with clinical characteristics and postoperative neurological outcome

Tinu Ravi Abraham, Shaju Mathew, P. K. Balakrishnan, Ajax John, Haris Thottathil Pareed, Tom Jose


Background: The pressure of the chronic SDH (subdural haemotoma), the age of the patient, preoperative GCS score and midline shift were considered prognostic dependent factors. The study aimed at the significance of the pressure of chronic SDH in the outcome of patients.

Methods: A correlation between subdural hematoma pressure and preoperative and postoperative clinical variables such as hematoma volume, midline shift, age, GCS score and postoperative modified ranking scale score as well as complications were assessed and analyzed.

Results: According to the pressure of chronic SDH, 56 patients were grouped into 4 groups. In the pressure group <15 cm/h20 group the mean age was 85 and postoperative ranking score was 3 and the recurrence was 21 % while in high pressure group (>25 cm/h20) the mortality was 14% and no recurrence.

Conclusions: The pressure of the chronic SDH has significant prognostic value in chronic SDH surgeries.


Chronic SDH, Pressure gradient, Prognostic factors

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Sundstrøm T, Helland CA, Aarhus M, Wester K. What is the pressure in chronic subdural hematomas? a prospective, population-based study. J Neurotrauma. 2012;29(1):137-42.

Winn HR. Youmans and Winn Neurological Surgery. 7th ed. Elsevier; 2017:12301.

Tanaka A, Nakayama Y, Yoshinaga S. Cerebral blood flow and intracranial pressure in chronic subdural hematomas. Surg Neurol. 1997;47(4):346-51.

Sundstrøm T, Helland CA, Aarhus M, Wester K. What is the pressure in chronic subdural hematomas? A prospective, population-based study. J Neurotrauma. 2012;29(1):137-42.

Kopitnik TA, Deandrade R, Gold MA, Robert Nugent G. Pressure changes within a chronic subdural hematoma during hemodialysis. Surg Neurol. 1989;32(4):289-93.

Ishikawa T, Kawamura S, Hadeishi H, Suzuki A, Yasui N, Shishido F, et al. Uncoupling between CBF and oxygen metabolism in a patient with chronic subdural haematoma: case report. J Neurol Neurosurg Psychiatry. 1992;55(5):401-3.

Santarius T, Lawton R, Kirkpatrick PJ, Hutchinson PJ. The management of primary chronic subdural haematoma: a questionnaire survey of practice in the United Kingdom and the Republic of Ireland. Br J Neurosurg. 2008;22(4):529-34.

Cenic A, Bhandari M, Reddy K. Management of chronic subdural hematoma: a national survey and literature review. Can J Neurol Sci. 2005;32(4):501-6.

Karibe H, Kameyama M, Kawase M, Hirano T, Kawaguchi T, Tominaga T. Epidemiology of chronic subdural hematoma. No Shinkei Geka. 2011;39(12):1149-53.

Kim BG, Lee KS, Shim JJ, Yoon SM, Doh JW, Bae HG. What determines the laterality of the chronic subdural hematoma? J Korean Neurosurg Soc. 2010;47(6):424-7.

Choi WW, Kim KH. Prognostic factors of chronic subdural hematoma. J Korean Neurosurg Soc. 2002;32(1):18-22.

El-Kadi HM, Kaufman HH. Prognosis of chronic subdural hematomas. Neurosurg Clin N Am. 2000;11(18):553-67.

Miah IP, Tank Y, Rosendaal FR. Radiological prognostic factors of chronic subdural hematoma recurrence: a systematic review and meta-analysis. Neuroradiology. 2021;63(1):27-40.

Kang MSK, Kwon HJ, Cho SW, Kim SH, Youm JY. Factors influencing recurrent chronic subdural hematoma after surgery. J Korean Neurosurg Soc. 2007;41(1):11-5.

Ramachandran R, Hegde T. Chronic subdural hematomas--causes of morbidity and mortality. Surg Neurol. 2007;67(4):367-72.