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已发表论文
术中跨越大脑外侧裂且未阻塞大脑中动脉的慢性硬膜下血肿囊肿与术后复发相关
Received 15 September 2025
Accepted for publication 20 December 2025
Published 8 January 2026 Volume 2026:19 567757
DOI https://doi.org/10.2147/IJGM.S567757
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Redoy Ranjan
Sen He,1 Fang Xue,1 Mingli Wei2
1Department of Neurosurgery, West China Hospital of Sichuan University-Ziyang Hospital & Ziyang Central Hospital, Ziyang, Sichuan, 641300, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University-Ziyang Hospital & Ziyang Central Hospital, Ziyang, Sichuan, 641300, People’s Republic of China
Correspondence: Mingli Wei, Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University-Ziyang Hospital & Ziyang Central Hospital, No. 66, Rende west Road, Yanjiang District, Ziyang, Sichuan, 641300, People’s Republic of China, Email mmmlweihop@outlook.com
Background: Despite advances in surgical techniques, recurrence after chronic subdural hematoma (CSDH) evacuation remains common. With the aging of the population, the incidence rate is still rising. Most patients require surgical treatment, but postoperative hematoma recurrence remains an important factor affecting patient prognosis.
Objective: This study aimed to identify factors influencing recurrence following neuroendoscopic-assisted drainage.
Methods: CSDH patients who underwent neuroendoscopy-assisted hematoma drainage(NEAHD) via a single burr-hole craniostomy between January 2021 and August 2024 were categorized based on the presence or absence of postoperative hematoma recurrence. Binary logistic regression analysis was performed on the variables that showed statistically significant inter-group differences in univariate analyses.
Results: In total, 121 patients with CSDH were included. The recurrence group consisted of 17 patients (14.05%). Gender, age, smoking, alcoholism, hypertension or diabetes, perioperative use of statins, hematoma thickness, midline deviation distance, and direction, depth, and retention time of the drainage tube were not associated with hematoma recurrence. In contrast, hematoma capsule spanning the Sylvian fissure (P < 0.001; OR = 12.504; 95% CI, 3.091– 50.583) and non-blocking the main trunk or major branches of the middle meningeal artery (MMA) (P = 0.006; OR = 9.955; 95% CI, 1.911– 51.848) were the independent risk factors for hematoma recurrence after NEAHD surgery.
Conclusion: Spanning of the hematoma capsule over the Sylvian fissure and absence of intraoperative occlusion of the middle meningeal artery are independent risk factors for recurrence. These features should be considered when planning surgical strategies for CSDH.
Keywords: chronic subdural hematoma, neuroendoscopy, surgery, prognosis, recurrence
1Department of Neurosurgery, West China Hospital of Sichuan University-Ziyang Hospital & Ziyang Central Hospital, Ziyang, Sichuan, 641300, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University-Ziyang Hospital & Ziyang Central Hospital, Ziyang, Sichuan, 641300, People’s Republic of China
Correspondence: Mingli Wei, Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University-Ziyang Hospital & Ziyang Central Hospital, No. 66, Rende west Road, Yanjiang District, Ziyang, Sichuan, 641300, People’s Republic of China, Email mmmlweihop@outlook.com
Background: Despite advances in surgical techniques, recurrence after chronic subdural hematoma (CSDH) evacuation remains common. With the aging of the population, the incidence rate is still rising. Most patients require surgical treatment, but postoperative hematoma recurrence remains an important factor affecting patient prognosis.
Objective: This study aimed to identify factors influencing recurrence following neuroendoscopic-assisted drainage.
Methods: CSDH patients who underwent neuroendoscopy-assisted hematoma drainage(NEAHD) via a single burr-hole craniostomy between January 2021 and August 2024 were categorized based on the presence or absence of postoperative hematoma recurrence. Binary logistic regression analysis was performed on the variables that showed statistically significant inter-group differences in univariate analyses.
Results: In total, 121 patients with CSDH were included. The recurrence group consisted of 17 patients (14.05%). Gender, age, smoking, alcoholism, hypertension or diabetes, perioperative use of statins, hematoma thickness, midline deviation distance, and direction, depth, and retention time of the drainage tube were not associated with hematoma recurrence. In contrast, hematoma capsule spanning the Sylvian fissure (P < 0.001; OR = 12.504; 95% CI, 3.091– 50.583) and non-blocking the main trunk or major branches of the middle meningeal artery (MMA) (P = 0.006; OR = 9.955; 95% CI, 1.911– 51.848) were the independent risk factors for hematoma recurrence after NEAHD surgery.
Conclusion: Spanning of the hematoma capsule over the Sylvian fissure and absence of intraoperative occlusion of the middle meningeal artery are independent risk factors for recurrence. These features should be considered when planning surgical strategies for CSDH.
Keywords: chronic subdural hematoma, neuroendoscopy, surgery, prognosis, recurrence