ObjectiveTo compare the clinical features and imaging differences between unilateral and bilateral chronic subdural hematoma(CSDH), and investigate the treatment strategies of bilateral CSDH.

MethodsThe clinical data of 57 pateints with CSDH were retrospectively analyzed, and divided into the unilateral CSDH group and bilateral CSDH group according to CT scan findings.The clinical characteristics, imaging findings and recurrence rate between two groups were compared.The bilateral CSDH patients were subdivided into the bilateral operation group and unilateral operation group according to different surgical methods, and the recurrence rate between two group was analyzed.

ResultsThe differences of the muscle weakness, dizziness, headache, language disorder, epilepsy, consciousness disorder, brain injury, use of anticoagulant/antiplatelet drugs and recurrence rate between two groups were not statistically significant(P>0.05).The mean distance of CT midline shift in unilateral CSDH group was higher than that in bilateral CSDH group, and the thickness of hematoma was lower in unilateral CSDH group than that in bilateral CSDH group(P < 0.01).The average maximum hematoma thickness in bilateral CSDH patients treated with bilateral drilling drainage was higher than that in unilateral operation patients(P < 0.05).There was no statistical significance in the mean distance of midline shift and recurrence rate between bilateral operation group and unilateral operation group(P>0.05).

ConclusionsThe imaging characteristics bewteen unilateral and bilateral CSDH are different.Some patients with bilateral CSDH can be cured by unilateral drilling drainage.