AIM: To determine risk factors predicting chronic subdural hematoma (CSH) recurrence is a common type of intracranial hemorrhage in elderly patients. Despite improved medical diagnosis and treatment, the reoperation rate remains high.

MATERIAL and METHODS: A retrospective review of 291 CSH patients admitted to our department was performed. Clinical and radiological factors predictive for CSH recurrence were identified by univariate analyses; variables whose p-value was <0.05 underwent multivariate logistic regression analyses.

RESULTS: Univariate analyses revealed that preoperative midline shift (p=0.025), mix-density hematoma (p=0.023), internal architecture of hematoma (p=0.044), membranectomy (p=0.001), and ambient cistern compression (p=0.001) correlated with a significantly higher rate of recurrence. Multivariate analyses showed that separated architecture, membranectomy and ambient cistern compression were independent risk factors for CSH recurrence.

CONCLUSION: Among many factors, membranectomy, separated architecture, and ambient cistern compression were the strongest predictors for recurrence.