Correlation study between temporal muscle thickness and recurrence in patients with chronic subdural hematoma after burr hole drainage

doi:10.3877/cma.j.issn.2095-9141.2025.03.006

Abstract

Abstract:

Objective

To analyze the correlation between temporal muscle thickness (TMT) and postoperative recurrence in patients with chronic subdural hematoma (CSDH) who underwent burr hole drainage.

Methods

A retrospective analysis was conducted on the clinical data of 108 CSDH patients who received burr hole drainage in the Neurosurgery Department of Taihe County People's Hospital from January 2021 to December 2023. TMT was measured by preoperative head CT scan. Patients were stratified by gender, and their TMT was compared between males and females. The receiver operating characteristic (ROC) curve and maximum Jordan index were used to determine the gender specific threshold for TMT. Based on this threshold, patients were divided into a low temporal muscle thickness (LTMT) group and a high temporal muscle thickness (HTMT) group, and their clinical data were compared between the two groups. According to whether the patient has a recurrence 6 months after surgery, they were divided into a recurrence group and a non-recurrence group. Adopting multiple Logistic regression analysis to identify independent risk factors for postoperative recurrence in CSDH patients.

Results

Among the 108 patients, there were 19 patients in the recurrence group and 89 patients in the non-recurrence group. The TMT of male patients was significantly higher than that of females, and the difference was statistically significant (P<0.05). ROC curve analysis showed that the optimal TMT threshold for predicting recurrence was 4.175 mm for males and 3.300 mm for females. There were 56 cases in the HTMT group and 52 cases in the LTMT group. The recurrence rate of patients in the LTMT group was higher than that in the HTMT group, and the difference was statistically significant (P<0.05). Multivariate Logistic regression analysis showed that age ≥70 years, TMT≤critical value (4.175 mm for males and 3.300 mm for females), and hematoma volume were independent risk factors for postoperative recurrence in CSDH patients.

Conclusions

Preoperative TMT below the gender specific threshold is an independent risk factor for postoperative recurrence in CSDH patients, and its predictive value is not affected by age and hematoma volume, which helps identify patients at high risk of recurrence.

Key words: Temporal muscle thickness, Chronic subdural hematoma, Burr hole drainage, Recurrence

Yonghui Huang, Baohua Fan, Tian Huai, Jianqiang Ma, Rujiang Bai. Correlation study between temporal muscle thickness and recurrence in patients with chronic subdural hematoma after burr hole drainage[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2025, 11(03): 174-179.

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Figures/Tables 6

References 27

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项目	复发组（n=19）	未复发组（n=89）	χ²/Z/t值	P值
年龄[例（%）]			7.347	0.007
≥70岁	18（94.7）	56（63.9）
<70岁	1（5.3）	33（37.1）
性别（男/女）	16/3	67/22	0.702	0.402
TMT[mm，M（IQR）]	3.45（1.33）	4.15（1.25）	-2.336	0.019
血肿量（mL，±s）	85.30±29.91	101.16±28.49	2.095	0.039
BMI（mm，±s）	25.75±5.27	26.04±5.03	0.226	0.822
抗凝或抗血小板药物使用史[例（%）]	1（5.3）	2（2.2）	0.527	0.468
APTT（mm，±s）	30.79±5.05	31.58±5.64	0.562	0.575
血肿分隔[例（%）]	2（10.5）	4（4.5）	1.086	0.297
中线偏移（mm，±s）	9.28±1.83	8.75±2.15	0.987	0.326

项目	复发组（n=19）	未复发组（n=89）	χ²/Z/t值	P值
年龄[例（%）]			7.347	0.007
≥70岁	18（94.7）	56（63.9）
<70岁	1（5.3）	33（37.1）
性别（男/女）	16/3	67/22	0.702	0.402
TMT[mm，M（IQR）]	3.45（1.33）	4.15（1.25）	-2.336	0.019
血肿量（mL，±s）	85.30±29.91	101.16±28.49	2.095	0.039
BMI（mm，±s）	25.75±5.27	26.04±5.03	0.226	0.822
抗凝或抗血小板药物使用史[例（%）]	1（5.3）	2（2.2）	0.527	0.468
APTT（mm，±s）	30.79±5.05	31.58±5.64	0.562	0.575
血肿分隔[例（%）]	2（10.5）	4（4.5）	1.086	0.297
中线偏移（mm，±s）	9.28±1.83	8.75±2.15	0.987	0.326

分组	ICC（95%CI）
测量者内
测量者1.1 vs测量者1.2	0.960（0.921~0.982）
测量者2.1 vs测量者2.2	0.942（0.891~0.973）
测量者间
测量者1.1 vs测量者2.1	0.973（0.942~0.981）
测量者1.2 vs测量者2.2	0.951（0.912~0.970）
测量者1.1 vs测量者2.2	0.983（0.953~0.991）
测量者1.2 vs测量者2.1	0.931（0.861~0.960）

分组	ICC（95%CI）
测量者内
测量者1.1 vs测量者1.2	0.960（0.921~0.982）
测量者2.1 vs测量者2.2	0.942（0.891~0.973）
测量者间
测量者1.1 vs测量者2.1	0.973（0.942~0.981）
测量者1.2 vs测量者2.2	0.951（0.912~0.970）
测量者1.1 vs测量者2.2	0.983（0.953~0.991）
测量者1.2 vs测量者2.1	0.931（0.861~0.960）

项目	HTMT组（n=56）	LTMT组（n=52）	χ²/t值	P值
年龄[例（%）]			3.284	0.070
≥70岁	34（60.7）	40（76.9）
<70岁	22（29.2）	12（23.1）
性别（男/女）	45/11	38/14	0.803	0.370
复发[例（%）]	4（7.1）	15（28.8）	8.718	0.003
血肿量（mL，±s）	92.20±30.86	85.27±29.52	1.167	0.246
术前中线偏移（mm，±s）	8.81±2.30	8.89±1.88	0.199	0.843

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