Anatomical regions of residual hemorrhage in chronic subdural hematoma

Abstract Background Chronic subdural hematoma (CSH) is a persistent challenge for neurosurgeons, with current relapse, mortality, and morbidity rates not meeting desired outcomes. This study aims to identify the anatomical regions of postoperative residual hemorrhage and discuss their potential implications for surgical practice. Methods This retrospective, observational study reviewed the demographic, clinical, functional, and radiographic outcomes of 74 patients who underwent surgery for CSH between January 1, 2017, and October 1, 2021, at a single-center. Data were collected from the hospital's electronic database, including patient history, physical examination records, and preoperative and postoperative imaging. Results Postoperative day 1 computed tomography scans revealed the most common region for residual hemorrhage was the inferior frontal gyrus in 17 cases (23.0%; valid percentage: 42.5%). Residual hemorrhage was detected in the superior parietal lobe in 9 cases (12.2%; valid percentage: 22.5%). High valid percentages of residual hemorrhage were also noted in the temporal (62.5%) and occipital (66.6%) regions. Conclusions The inferior frontal gyrus, temporal, and occipital regions are the most common sites for postoperative residual hemorrhage in CSH patients. Identifying these regions can guide surgical planning and intraoperative focus, potentially improving patient outcomes. This study provides valuable insights for refining presurgical strategies and targeting specific anatomical areas during surgery.