{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T11:22:01Z","timestamp":1779103321450,"version":"3.51.4"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Sarcopenia is increasingly recognized as a prognostic factor in surgical populations. This study evaluated the association between cranial CT-based markers of sarcopenia and neurological outcomes in patients undergoing surgery for chronic subdural hematoma (CSDH). Methods: This retrospective case\u2013control study included 82 patients who underwent surgery for unilateral CSDH. Demographic data, comorbidities, use of anticoagulant and antiplatelet therapy, postoperative complications and length of hospital stay were collected from patients\u2019 medical records. Radiological parameters of sarcopenia, including temporal muscle thickness, temporal muscle area, and occipital fat pad thickness, as well as standard radiological features of CSDH, were measured preoperatively on the initial CT scan. Neurological outcome 3 months after surgery was assessed using the Glasgow Outcome Scale, with scores \u2265 4 defined as favourable and scores 1\u20133 as poor. Results: Demographic and clinical characteristics, including age, sex, comorbidities, hematoma thickness and intracranial midline shift, did not differ significantly between outcome groups. Temporal muscle thickness (4.7 vs. 2.8 mm, p &lt; 0.001), temporal muscle area (160 vs. 106 mm2, p = 0.04), and occipital fat pad thickness (4.7 vs. 3.4 mm, p = 0.04) were significantly greater in patients with favourable neurological outcomes. After corrections for age and comorbidities, multivariate logistic regression with temporal muscle thickness, area and density, temporal bone thickness and density, and occipital fat pad thickness demonstrated that temporal muscle thickness was the only independent predictor of good neurological recovery (OR 3.20, 95% CI 1.37\u20137.46, p = 0.007). ROC analysis showed good discriminatory power of temporal muscle thickness (AUC 0.812, 95% CI 0.695\u20130.930, p &lt; 0.001), with a cut-off value of \u22653.37 mm for its ability to predict favourable neurological outcome. Conclusions: Temporal muscle thickness is a reliable, non-invasive imaging biomarker for predicting good neurological recovery after CSDH surgery and may aid in risk stratification, particularly in elderly or frail patients.<\/jats:p>","DOI":"10.3390\/diagnostics16091279","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T08:08:02Z","timestamp":1777018082000},"page":"1279","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Muscle Thickness Is a Prognostic Factor for Neurological Recovery After Surgery for Chronic Subdural Hematoma"],"prefix":"10.3390","volume":"16","author":[{"given":"Nikolina","family":"\u0160ilje\u0161","sequence":"first","affiliation":[{"name":"Department of Radiology, University Hospital Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Mio\u010di\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Bagi\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5832-1745","authenticated-orcid":false,"given":"Zdravka","family":"Krivdi\u0107 Dupan","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Mu\u017eevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Veki\u0107 Mu\u017eevi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Department of Dermatology, University Hospital Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4483-9364","authenticated-orcid":false,"given":"Bruno","family":"Splavski","sequence":"additional","affiliation":[{"name":"University of Applied Health Sciences, 10000 Zagreb, Croatia"},{"name":"Department of Surgery Service of Neurosurgery, Dubrovnik General Hospital, 20000 Dubrovnik, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"\u0160imati\u0107","sequence":"additional","affiliation":[{"name":"Health Centre Osijek-Baranja County, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"\u0160utalo","sequence":"additional","affiliation":[{"name":"Health Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Major","sequence":"additional","affiliation":[{"name":"Department of Clinical Transfusion, Osijek University Hospital Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1160-163X","authenticated-orcid":false,"given":"Nenad","family":"Ne\u0161kovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"International Medical Center Priora, 31431 \u010cepin, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e134","DOI":"10.1097\/TA.0000000000003404","article-title":"Paradigms in chronic subdural hematoma pathophysiology: Current treatments and new directions","volume":"91","author":"Bounajem","year":"2021","journal-title":"J. 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