Chronic subdural hematoma: necessity of irrigation and predictive factors of recurrence

Objective: Various factors that are related to the recurrence of chronic subdural hematomas have been described previously. The aims of this study were to identify the recurrence-related factors and determine if irrigation of the hematoma cavity is necessary.
Methods: The records of a sequential series of patients with chronic subdural hematomas who were treated over a period of 3 years were retrospectively reviewed. We analyzed the sex, age, past histories, and efficiency of the irrigation procedures in conjunction with recurrence.
Results: The records of 82 patients were reviewed. Recurrence occurred in eight patients. Bilateral hematoma and a history of liver dysfunction were the significant risk factors for recurrence. In contrast, anticoagulant intake, alcohol abuse, and apparent trauma history did not affect the recurrence rate. Drainage without irrigation did not affect the recurrence rate and significantly decreased the operation time.
Conclusions: Bilateral hematoma and liver dysfunction are predictive of recurrence in chronic subdural hematomas. Since drainage without irrigation did not affect the recurrence rate and significantly decreased the operation time, irrigation can be omitted from the surgical procedures for chronic subdural hematoma.