Objective: Even though bilateral chronic subdural hematoma (CSDH) constitutes about 15% to 20% of all CSDH, relatively scanty data have been demonstrated. We retrospectively reviewed clinical manifestations and postoperative drainage volumes of bilateral CSDH patients, and compared them with those of unilateral CSDH. Methods: A total of 50 cases of bilateral CSDH were retrospectively investigated. Of these, 45 patients had surgery: 37 patients for both sides and 8 patients for symptomatic sides

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... only. Burr-hole craniotomies with irrigation and closed-system drainage were performed in all patients for 5 days. Results: In compared with unilateral CSDH, symptoms of headache and numbers of patients with predisposing factors found in more frequently in bilateral ones. Most of the bilaterally operated cases, drainage volumes of each side were largely different and it was significantly related to older age. There were 4 recurrences, which were not related to differences of drainage amount, but with low volumes of drainage. In addition, in patients operated symptomatic sides only, two cases had to be operated on the other sides later for enlarging hematomas. Conclusion: In bilateral CSDH cases, symptoms of headache and predisposing factors are more common than unilateral ones. Postoperative drainage volumes on each side of bilateral CSDH are largely different in most cases and age seems to attribute to this finding. Additionally, relatively large numbers(25%) of unilaterally operated cases needed additional surgery on opposite side, so careful follow-up study should be considered. 서 론 만성 경막하 혈종은 노년층에서 흔히 발생하며, 비교적 간 단한 수술적 요법으로 치료가 가능한 단순한 질병으로 여기 기 쉬우나 기존 연구에 따르면 20.5%의 수술 합병증과 13.3% 의 치사율을 보였다고 보고 되었으며 7) , 수술 후 재발률도 노 년층의 경우 8%에서 37%까지 보고되고 있다 12) . 치료 방법은 소천공기(twist-drill)나 천공기(burr hole)를 이용하여 두개골 천공 후 카테터를 통한 수 일간의 배액 방법을 이용하는데, 양측성 경막하 혈종인 경우 한쪽의 혈종량이 많지 않은 경 우, 양측 모두 수술을 해야 하는 지와 어느쪽을 먼저 수술해 야 하는지, 또한 빠른 감압 뒤에 반대쪽에서 발생할 수 있는