Imran Altaf, Muhammad Rizwan Sarwar.
Relationship between postoperative pneumocephalus and recurrence following chronic subdural hematoma evacuation.
Pak J Neuro Surg Jan ;27(1):29-34.

Objective: Postoperative pneumocephalus has been reported as one of the possible causes of increased recurrence following burrhole evacuation of chronic subdural hematoma (ChSDH). The present study was designed to assess the relationship between postoperative pneumocephalus and recurrence following chronic subdural hematoma evacuation. Materials and Methods: The medical records of sixty eight patients that had been operated for ChSDH evacuation with burrhole drainage were retrospectively analyzed. The area of the pneumocephalus was measured in the slice where the size of the pneumocephalus was the biggest. The patients were then divided into the recurrent and the non-recurrent groups and compared for their association with the postoperative pneumocephalus. Patients with a pneumocephalus size of > 4 cm2 and those with a size ? 4 cm2 were also compared with each other for recurrence. Results: Fourteen (20.6%) patients had recurrence following burrhole evacuation of ChSDH. The mean size of the pneumocephalus in the recurrent group was 7.88 +- 5.12 cm2 and in the non-recurrent group was 6.56 +- 5.56 cm2.The size of the pneumocephlus was not statistically different (p=0.42) between the two groups. We also compared patients with a pneumocephalus size of > 4 cm2 and those with a pneumocephalus size of ? 4 cm2 and again found that the relationship with recurrence was not significant (p=0.288). Conclusion: We conclude that postoperative pneumocephalus is not associated with recurrence following burrhole evacuation of chronic subdural hematoma. Keywords: Postoperative pneumocephalus, burrhole evacuation, recurrence, chronic subdural hematoma

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