Postoperative pneumocephalus increases the recurrence rate of chronic subdural hematoma.

OBJECTIVES: Pneumocephalus is a common operative complication of chronic subdural hematoma. This study is to analyze the relationship between postoperative pneumocephalus and the recurrence and surgical outcomes.

PATIENTS AND METHODS: This is a retrospective case-cohort study, including a pneumocephalus group (n = 46) and a control group (n = 181). Their recurrence rates, CT attenuation values, hospital stay, healing time and the neurological status were recorded and analyzed.

RESULTS: The pneumocephalus group had a recurrence rate of 32.6%, significantly higher than the control (17.7%). In addition, the pneumocephalus group had a higher rate of postoperative epilepsy (21.7% vs 3.3%), longer hospital stay (11.5 ± 2.8 vs 7.8 ± 1.2 days), longer healing time (10.8 ± 5.4 vs 6.5 ± 2.3 months), and worse neurological scores than the control.

CONCLUSION: Pneumocephalus increases the recurrence rate of chronic subdural hematoma, and it not only prolongs the hospital stay and healing time, but also leads to deterioration of the neurological status.