{"id":"d7ce1507-83cd-4c4b-a235-952a356ac538","slug":"chronic-subdural-hematoma-clinical-experience-and-recurrence-risk-factors-in-a-mexican-neurosurgery-residency-training-program","title":"Chronic subdural hematoma: Clinical experience and recurrence risk factors in a Mexican neurosurgery residency training program","authors":["Aurelio Ponce-Ayala","José de Jesús Gutiérrez-Baños","Rafael Mendizabal-Guerra","Mauricio Ivan Rodriguez-Pereira","Juan Carrizales-Rodriguez"],"abstract":"Background: Chronic subdural hematoma (CSDH) recurrence remains a challenge, with risk factors still debated. Methods: A retrospective review of 185 CSDH cases surgically treated at Hospital Juárez de México (2014–2019) was conducted. Recurrence was defined as clinical deterioration with radiological re-expansion. Demographic, clinical, imaging and perioperative variables were analyzed statistically (P < 0.05). Results: The cohort included 145 males (78.4%) median age of 55 years. Head trauma was present in 75.7%. Hematomas were mostly chronic (69.2%), with 49.18% showing heterogeneous density. The surgical approaches used were single burr-hole (4.3%), double burr-hole (10.8%), and craniotomy (84.9%). Recurrence occurred in 16 cases (8.4%), primarily within a week. The significant risk factors for recurrence included thrombocytopenia (P = 0.001) and prolonged partial thromboplastin time (>38.6 s, P = 0.005). Craniotomy had lower recurrence (7%) than burr-holes (P = 0.053). Conclusion: Thrombocytopenia and coagulopathy increase recurrence risk in CSDH. Craniotomy may reduce recurrence compared to burr-hole techniques. Further studies are needed to optimize surgical management.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/d7ce1507-83cd-4c4b-a235-952a356ac538/featured/hero-1781558629775.png","publishDate":"2025-05-16T00:00:00.000Z","doi":"10.25259/SNI_71_2025","categories":["General Neurosurgery","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2025/05/13560/SNI-16-181.pdf"}