Zhang et al reported a score for predicting reoperation for contralateral hematoma growth after unilateral evacuation of bilateral chronic subdural hematoma. The authors are from multiple institutions in Singapore and England.
Patient selection: chronic bilateral subdural hematoma, after unilateral evacuation
Parameters:
(1) anticoagulation
(2) maximum axial thickness of hematoma over undrained side in mm
Parameter
Finding
Points
anticoagulation
no
0
yes
2
maximum axial thickness
<= 9 mm
0
> 9 mm
1
total score =
= SUM(points for both variables)
Interpretation:
• minimum score: 0
• maximum score: 3
Total Score
Risk Level
Reoperation for Contralateral Hematoma
0
low
1.6%
1
moderate
3.6%
2
high
16.7%
3
very high
50%
Performance:
• The area under the ROC curve is 0.67.
A preoperative maximum axial thickness <= 9 mm for the contralateral side is 4 times more likely to completely resolve eventually.
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