title: [Chronic subdural haematomas. The internal architecture of the haematoma as a predictor of recurrence].
abstract: BACKGROUND
  The internal architecture of a chronic subdural haematoma (CSDH) is an important factor that must be taken into account as a predictor of recurrence.
  
  
  OBJECTIVE
  To analyse the factors that are possibly associated to the recurrence of CSDH, with special emphasis on the above-mentioned architecture.
  
  
  METHODS
  We reviewed 147 patients treated between 2010 and 2013. The CSDH were classified into four types, in accordance with Nakaguchi's classification published in 2001. Moreover, we gathered different clinical characteristics and they were submitted to a statistical analysis in order to evaluate the possible association between them and the rate of recurrence of CSDH.
  
  
  RESULTS
  The rate of recurrence was 14.75% and the mortality rate was 4.76%. Treatment with anticoagulants, the type of haematoma and not using subdural drainage were statistically significant risk factors for the recurrence of CSDH. In terms of the internal architecture, the rate of recurrence was 36.36% for the separated type, 15.90% for the laminar type, 8.82% for the homogenous and 0% for the trabecular type. This rate was significantly higher in the separated type with respect to the homogenous and trabecular types.
  
  
  CONCLUSIONS
  We have observed that treatment with anticoagulants and not using subdural drainage are risk factors for the recurrence of CSDH. Furthermore, dividing CSDH up in accordance with Nakaguchi's classification can be useful for predicting the risk of relapse, since the rate of recurrence of the separated type was significantly greater than that of the other types.
authors.affiliation: Hospital Universitario de la Princesa, 28006 Madrid, Espana.
authors.forename: M Ángeles
authors.initials: MÁ
authors.lastname: García-Pallero
authors.forename: Paloma
authors.initials: P
authors.lastname: Pulido-Rivas
authors.forename: José M
authors.initials: JM
authors.lastname: Pascual-Garvi
authors.forename: Rafael G
authors.initials: RG
authors.lastname: Sola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D014057:Tomography, X-Ray Computed