title: Predicting Factors of Chronic Subdural Hematoma Following Surgical Clipping in Unruptured and Ruptured Intracranial Aneurysm.
abstract: OBJECTIVE
  The aim of this study is to analyze the differences in the incidence, predicting factors, and clinical course of chronic subdural hematoma (CSDH) following surgical clipping between unruptured (UIA) and ruptured intracranial aneurysm (RIA).
  
  
  METHODS
  We conducted a retrospective analysis of 752 patients (UIA : 368 and RIA : 384) who underwent surgical clipping during 8 years. The incidence and predicting factors of CSDH development in the UIA and RIA were compared according to medical records and radiological data.
  
  
  RESULTS
  The incidence of postoperative CSDH was higher in the UIA (10.9%) than in the RIA (3.1%) (p=0.000). In multivariate analysis, a high Hounsfield (HF) unit (blood clots) for subdural fluid collection (SFC), persistence of SFC ≥5 mm and male sex in the UIA and A high HF unit for SFC and SFC ≥5 mm without progression to hydrocephalus in the RIA were identified as the independent predicting factors for CSDH development (p<0.05).
  
  
  CONCLUSIONS
  There were differences in the incidence and predicting factors for CSDH following surgical clipping between UIA and RIA. Blood clots in the subdural space and persistence of SFC ≥5 mm were predicting factors in both UIA and RIA. However, progression to hydrocephalus may have in part contributed to low CSDH development in the RIA. We suggest that cleaning of blood clots in the subdural space and efforts to minimize SFC ≥5 mm at the end of surgery is helpful to prevent CSDH following aneurysmal clipping.
authors.affiliation: Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Min-Yong
authors.initials: MY
authors.lastname: Kwon
authors.affiliation: Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Chang-Hyun
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Chang-Young
authors.initials: CY
authors.lastname: Lee
keywords: Chronic subdural hematoma; Intracranial aneurysm; Surgical clipping