{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T09:29:23Z","timestamp":1761902963901,"version":"build-2065373602"},"reference-count":37,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Routine postoperative computed tomography (CT) scan in chronic subdural hematoma (cSDH) management is not supported by literature. Yet, many institutions perform routine postoperative scans for several reasons. The dangers are potential for abuse, healthcare cost, and unnecessary exposure to ionizing radiation.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Data were collected prospectively on patients who had surgery for cSDH between January 2021 and December 2023. Number of postoperative CT, complication rate, average length of hospital stay, recurrence rate, and functional outcome were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n One hundred and six patients had surgery and 6 months follow-up record after surgery. There were 89 males (84%) and 17 females (16%). Of the 11 (10.38%) patients who had postoperative brain CT, three had postoperative scan due to new neurological deficits, four did not improve 48 h after surgery, one had cortical injury, and three had initial improvement but then deteriorated within 1 week. Our data showed recurrence in 7 (6.6%) patients, deep vein thrombosis 2 (1.9%), and wound infection and subdural empyema 1 (0.9%). Duration of hospital admission significantly affected complication; 5.9% in patients who stayed <7 days on admission against 18.4% in those who stayed more than 7 days (\n P<\/jats:italic>\n = 0.05). Outcome at 6 months revealed that 100 (94.3%) patients had good outcome while 6 (5.7%) had bad outcome.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Routine brain CT scan after uncomplicated drainage of cSDH in patients without new neurological symptoms adds no value. A rational clinical approach based on neurologic evaluation should guide the decision on a postoperative scan.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_745_2025","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T09:25:40Z","timestamp":1761902740000},"page":"452","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Protocol-based postoperative brain scan after drainage of chronic subdural hematoma in a low-resource setting (ProtoScan study)"],"prefix":"10.25259","volume":"16","author":[{"given":"Uchenna","family":"Ajoku","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Iroegbu-Emeruem","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rivers State University, Rivers State University Teaching Hospital, Port Harcourt, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"10.25259\/SNI_745_2025\/ref-1","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s12883-022-02857-1","article-title":"Predictors of recurrence of chronic subdural haematoma in a cohort study of patients presenting in a subSaharan African teaching hospital","volume":"22","author":"Abdullah","year":"2022","journal-title":"BMC Neurol"},{"key":"10.25259\/SNI_745_2025\/ref-2","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1080\/02688690701272232","article-title":"Outcomes and recurrence rates in chronic subdural haematoma","volume":"21","author":"Amirjamshidi","year":"2007","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-3","doi-asserted-by":"crossref","first-page":"101816","DOI":"10.1016\/j.inat.2023.101816","article-title":"Three-month outcome of patients operated for chronic subdural hematoma at four hospitals, Addis Ababa, Ethiopia, 2021GC","volume":"34","author":"Aseged","year":"2023","journal-title":"Interdiscip Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-4","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.clineuro.2012.10.008","article-title":"Anticoagulation therapy a risk factor for the development of chronic subdural hematoma","volume":"115","author":"Aspegren","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-5","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.wneu.2016.09.010","article-title":"Chronic subdural hematoma: A questionnaire survey of management practice in India and review of literature","volume":"96","author":"Avanali","year":"2016","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s13760-012-0130-1","article-title":"Ambivalence among neurologists and neurosurgeons on the treatment of chronic subdural hematoma: A national survey","volume":"113","author":"Berghauser Pont","year":"2013","journal-title":"Acta Neurol Belg"},{"key":"10.25259\/SNI_745_2025\/ref-7","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1017\/S0317167100004510","article-title":"Management of chronic subdural hematoma: A national survey and literature review","volume":"32","author":"Cenic","year":"2005","journal-title":"Can J Neurol Sci"},{"key":"10.25259\/SNI_745_2025\/ref-8","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.wneu.2020.08.118","article-title":"Outcomes of surgical evacuation of chronic subdural hematoma in the aged: Institutional experience and systematic review","volume":"144","author":"Dowlati","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-9","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s10143-011-0349-y","article-title":"The surgical management of chronic subdural hematoma","volume":"35","author":"Ducruet","year":"2012","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI_745_2025\/ref-10","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s00701-016-2820-6","article-title":"Is systematic post-operative CT scan indicated after chronic subdural hematoma surgery? A case-control study","volume":"158","author":"Dudoit","year":"2016","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_745_2025\/ref-11","first-page":"231","article-title":"Efficacy of the non-surgical treatment of chronic subdural hematoma: A systematic review","volume":"116","author":"El Wardany","year":"2023","journal-title":"QJM Monthly J Assoc Physicians"},{"key":"10.25259\/SNI_745_2025\/ref-12","doi-asserted-by":"crossref","first-page":"523","DOI":"10.4103\/1673-5374.293152","article-title":"Atorvastatin combined with low-dose dexamethasone for vascular endothelial cell dysfunction induced by chronic subdural hematoma","volume":"16","author":"Fan","year":"2021","journal-title":"Neural Regen Res"},{"key":"10.25259\/SNI_745_2025\/ref-13","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.wneu.2020.06.140","article-title":"Updates in chronic subdural hematoma: Epidemiology, etiology, pathogenesis, treatment, and outcome","volume":"141","author":"Feghali","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-14","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1227\/01.neu.0000430328.25516.dd","article-title":"An evidence-based approach to the efficient use of computed tomography imaging in the neurosurgical patient","volume":"73","author":"Garrett","year":"2013","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_745_2025\/ref-15","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1093\/neuros\/nyaa447_368","article-title":"Statin use is associated with greater improvement in chronic subdural hematoma size on follow-up scan","volume":"67","author":"Guidry","year":"2020","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_745_2025\/ref-16","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.3171\/2018.8.JNS181767","article-title":"International practice variation in postoperative imaging of chronic subdural hematoma patients","volume":"131","author":"Hulsbergen","year":"2019","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-17","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.wneu.2015.10.025","article-title":"Surgical treatments for chronic subdural hematomas: A comprehensive systematic review","volume":"86","author":"Ivamoto","year":"2016","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-18","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.3171\/2009.11.JNS081048","article-title":"The clinical significance and optimal timing of postoperative computed tomography following cranial surgery","volume":"113","author":"Khaldi","year":"2010","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-19","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/S0020-1383(02)00020-7","article-title":"Chronic subdural haematoma in young and extremely aged adults: A comparative study of two age groups","volume":"33","author":"Liliang","year":"2002","journal-title":"Injury"},{"key":"10.25259\/SNI_745_2025\/ref-20","first-page":"101","article-title":"Outcome of chronic subdural hematoma treated with single burr hole under local anesthesia","volume":"30","author":"Mersha","year":"2020","journal-title":"Ethiop J Health Sci"},{"key":"10.25259\/SNI_745_2025\/ref-21","doi-asserted-by":"crossref","first-page":"791","DOI":"10.3171\/jns.2000.93.5.0791","article-title":"Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage","volume":"93","author":"Nakaguchi","year":"2000","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-22","doi-asserted-by":"crossref","first-page":"136","DOI":"10.4103\/2152-7806.141299","article-title":"Value of routine early post-operative computed tomography in determining short-term functional outcome after drainage of chronic subdural hematoma: An evaluation of residual volume","volume":"5","author":"Ng","year":"2014","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_745_2025\/ref-23","doi-asserted-by":"crossref","first-page":"e174","DOI":"10.1055\/s-0037-1607215","article-title":"No value of routine brain computed tomography 6 weeks after evacuation of chronic subdural hematoma","volume":"3","author":"Pedersen","year":"2017","journal-title":"Surg J (N Y)"},{"key":"10.25259\/SNI_745_2025\/ref-24","doi-asserted-by":"crossref","first-page":"7020","DOI":"10.1038\/s41598-022-10992-5","article-title":"Prognosis of patients with operated chronic subdural hematoma","volume":"12","author":"Posti","year":"2022","journal-title":"Sci Rep"},{"key":"10.25259\/SNI_745_2025\/ref-25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s41984-019-0054-7","article-title":"Chronic subdural hematomas: A case series from the medical ward of a north Tanzanian referral hospital","volume":"34","author":"Rashid","year":"2019","journal-title":"Egypt J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-26","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00701-015-2625-z","article-title":"Preoperative predictive factors for surgical and functional outcomes in chronic subdural hematoma","volume":"158","author":"Ro","year":"2016","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_745_2025\/ref-27","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4103\/2152-7806.161788","article-title":"Chronic subdural hematoma: Surgical management and outcome in 986 cases: A classification and regression tree approach","volume":"6","author":"Rovlias","year":"2015","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_745_2025\/ref-28","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.jocn.2004.12.013","article-title":"Chronic subdural haematomas and anticoagulation or anti-thrombotic therapy","volume":"13","author":"Rust","year":"2006","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_745_2025\/ref-29","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/02688690400004845","article-title":"Chronic subdural haematoma: Time to rationalize treatment?","volume":"18","author":"Santarius","year":"2004","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-30","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1080\/02688690802195381","article-title":"The management of primary chronic subdural haematoma: A questionnaire survey of practice in the United Kingdom and the Republic of Ireland","volume":"22","author":"Santarius","year":"2008","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-31","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s00701-012-1565-0","article-title":"Volume and densities of chronic subdural haematoma obtained from CT imaging as predictors of postoperative recurrence: A prospective study of 107 operated patients","volume":"155","author":"Stani\u0161i\u0107","year":"2013","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_745_2025\/ref-32","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1080\/02688690500305332","article-title":"Non-surgical primary treatment of chronic subdural haematoma: Preliminary results of using dexamethasone","volume":"19","author":"Sun","year":"2005","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-33","doi-asserted-by":"crossref","first-page":"222","DOI":"10.3171\/2016.9.JNS16623","article-title":"Present epidemiology of chronic subdural hematoma in Japan: Analysis of 63,358 cases recorded in a national administrative database","volume":"128","author":"Toi","year":"2018","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-34","doi-asserted-by":"crossref","first-page":"402","DOI":"10.2176\/nmc.ra.2016-0337","article-title":"Chronic subdural hematoma in elderly patients: Is this disease benign?","volume":"57","author":"Uno","year":"2017","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_745_2025\/ref-35","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1136\/jnnp.74.7.937","article-title":"Outcome of contemporary surgery for chronic subdural haematoma: Evidence based review","volume":"74","author":"Weigel","year":"2003","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.25259\/SNI_745_2025\/ref-36","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.wneu.2018.01.131","article-title":"Chronic subdural hematoma: So common and so neglected","volume":"111","author":"Welling","year":"2018","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_745_2025\/ref-37","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.nec.2016.11.002","article-title":"Chronic subdural hematoma: Epidemiology and natural history","volume":"28","author":"Yang","year":"2017","journal-title":"Neurosurg Clin N Am"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/protocol-based-postoperative-brain-scan-after-drainage-of-chronic-subdural-hematoma-in-a-low-resource-setting-protoscan-study\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/protocol-based-postoperative-brain-scan-after-drainage-of-chronic-subdural-hematoma-in-a-low-resource-setting-protoscan-study\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T09:26:14Z","timestamp":1761902774000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/protocol-based-postoperative-brain-scan-after-drainage-of-chronic-subdural-hematoma-in-a-low-resource-setting-protoscan-study\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":37,"alternative-id":["10.25259\/SNI_745_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_745_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,31]]},"article-number":"452"}}