Risk Factors for Pneumocephalus Following the Surgical Management of Chronic Subdural Hematoma

Introduction: Chronic subdural hematoma is an important type of hemorrhage that can cause morbidity and mortality in older people.The burr hole technique is employed in surgical treatment; however, postoperative pneumocephalus is a common complication of this surgery.To assess factors affecting the postoperative development of pneumocephalus in patients with chronic subdural hematoma.Methods: We analyzed 32 patients who underwent surgical treatment for chronic subdural hematoma using the burr hole technique at our clinic.Baseline and postoperative clinical and radiological data were evaluated.Variables that may affect the development of pneumocephalus, such as age, gender, neurological status, localization of subdural hematoma, thickness, unilaterality or bilaterality, and midline shift, were documented.These variables were analyzed and compared between patients with and without pneumocephalus. Results:The incidence of postoperative pneumocephalus was significantly higher in patients with bilateral hematoma than in those with unilateral hematoma (p=0.037;p<0.05).There was a significant difference between burr hole localizations among the patients based on the incidence of postoperative pneumocephalus (p=0.042;p<0.05).The incidence of pneumocephalus was high in patients undergoing surgery using the posterior approach.Conclusion: In the surgical treatment of chronic subdural hematoma, the burr hole technique is considered a safe option because it is effective, minimally invasive, and carries a low risk of complications.However, the occurrence of postoperative pneumocephalus and subsequent recurrent hemorrhage may necessitate reoperation.To prevent the development of pneumocephalus, the burr hole should be created as close to the anterior side as possible.