Take it seriously or not: postoperative pneumocephalus in CSDH patients?

Abstract

Background: Pneumocephalus is a common finding after burr-hole drainage of chronic subdural hematoma (CSDH). Its effects have not been specifically studied.

Methods: A retrospective analysis was performed in 140 patients with CSDH with single burr-hole drainage. The pre- and postoperative volumes of intracranial hematoma and the postoperative volume of pneumocephalus were calculated and analyzed with their relationships with Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) scores.

Results: The preoperative hematoma volume and the patient ages are positively correlated with the 1-day postoperative pneumocephalus volume (p < 0.001, p < 0.01). There is no correlation between postoperative pneumocephalus volume and GCS/GOS scores (p > 0.05) and there is no difference of GCS/GOS scores or CSDH recurrence rate between patients with and without pneumocephalus (p > 0.05). The age and the volume of 1-day postoperative pneumocephalus are positively correlated with the absorbing rate of pneumocephalus (p < 0.01, p < 0.001).

Conclusions: The pneumocephalus at a certain range has no effect on the prognosis of patients with CSDH and requires no specific intervention due to its self-absorbing capacity in the normal progress after surgery.

Highlights

• No correlation between postoperative pneumocephalus volume and GCS/GOS scores.

• No difference of GCS/GOS or recurrence between patients with pneumocephalus or not.

• Pneumocephalus at certain range has no effect on the prognosis of patients.

Keywords:

• Chronic subdural hematoma
• drilling and drainage
• pneumocephalus
• GCS
• GOS

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by Clinical Research Program of 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine [grant number JYLJ201802] and Shanghai Pudong New Area Health Science and Technology Project [grant number PW2018D-09].