Dive into the latest insights on the incidence and risk factors of chronic subdural hematoma following endoscopic endonasal surgery, exploring the pivotal role of pneumocephalus in postoperative complications.
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Incidence of and risk factors for chronic subdural hematoma after endoscopic endonasal surgery: quantitative analysis of pneumocephalus.
Umekawa et al., J Neurosurg 2024
<!– DOI: 10.3171/2024.1.JNS231953 //–>
https://doi.org/10.3171/2024.1.JNS231953
This study investigates the incidence and risk factors of chronic subdural hematoma (CSDH) following endoscopic endonasal surgery (EES), particularly focusing on the role of postoperative pneumocephalus. Data from 159 patients who underwent EES with intraoperative cerebrospinal fluid (CSF) leakage between November 2016 and December 2022 were analyzed. The incidence of post-EES CSDH was found to be 3.8%, exclusively occurring in patients with the highest grade of intraoperative CSF leakage (Esposito grade 3) and who had convexity pneumocephalus on immediate postoperative CT scans. A significant association was identified between the size of convexity pneumocephalus and the development of CSDH, with a specific cutoff value for predicting CSDH risk. The findings suggest that patients with significant convexity pneumocephalus post-EES are at a higher risk for CSDH and warrant close monitoring. This study contributes to the understanding of post-EES complications, highlighting the importance of pneumocephalus evaluation in preventing CSDH.