Surgical Management of Chronic Subdural Hematomas: An Institutional Analysis of Time to Hematoma Resolution.

Publication/Presentation Date

6-1-2026

Abstract

BACKGROUND AND OBJECTIVES: Chronic subdural hematoma (CSDH) management is evolving with the increasing use of middle meningeal artery embolization (MMAE). Limited data exist on the time to resolution (TTR) across different interventions. The aim of this study was to establish a baseline TTR for surgically treated CSDHs before MMAE implementation and compare it with TTR of MMAE.

METHODS: A retrospective analysis of 94 surgically treated CSDHs in 75 patients was performed. Kaplan-Meier survival analysis was used to model TTR for patients undergoing burr hole craniostomy (BHC), craniotomy, and twist drill craniostomy/subdural evacuating port system placement. Univariate and multivariate Cox regression analyses were performed to identify predictors of TTR. An unmatched cohort of 43 patients undergoing MMAE alone was underwent TTR analysis and compared with the surgical arm.

RESULTS: The median TTR for surgically treated CSDHs was 11 weeks, without significant difference between BHC and craniotomy groups. The median TTR for MMAE-treated patients was 14 weeks, significantly longer than craniotomy (

CONCLUSION: Resolution of CSDH commonly requires several months regardless of intervention type. Radiographic and clinical follow-up is widely variable. Although decompressive strategies achieve faster relief of mass effect and symptoms, interventions should consider the TTR and ability of patient to follow-up. Recognition of CSDH as a sentinel health event emphasizes the need for individualized treatment and long-term follow-up strategies.

Volume

7

Issue

2

First Page

000212

Last Page

000212

ISSN

2834-4383

Disciplines

Medicine and Health Sciences

PubMedID

41815204

Department(s)

Department of Surgery

Document Type

Article

Link to Full Text

Share

COinS