Abstract
BACKGROUND: Chronic subdural hematoma (CSDH) is a common neurosurgical condition that predominantly affects elderly individuals and is characterized by the accumulation of blood between the dura mater and the brain surface. Temporal muscle thickness (TMT) has emerged as a potential prognostic marker for various neurological diseases, including CSDH. This study aimed to evaluate the prognostic value of TMT in patients with CSDH. METHODS: This retrospective study assessed TMT in patients with CSDH using cranial CT scans. We examined the correlation between TMT and CSDH-related clinical characteristics and evaluated the prognostic relevance of TMT. RESULTS: A total of 844 participants were included in the study. TMT was significantly lower in patients with CSDH than in the control group (p < 0.001). The difference in TMT was strongly associated with the side of CSDH occurrence (p < 0.001), with CSDH more likely to develop on the side with lower TMT (OR = 0.219, 95% CI: 0.179-0.269). Lower average TMT was significantly associated with a higher likelihood of poor functional outcomes (OR = 0.560, 95% CI: 0.391-0.804, p = 0.002). Additionally, our analysis showed significant associations between TMT and age (p < 0.001), alcohol consumption (p = 0.009), cardiac disease (p = 0.006), brain infarction (p < 0.001), headache (p < 0.001), limb weakness (p < 0.001), and postoperative disturbance of consciousness (p = 0.029). CONCLUSION: The occurrence of CSDH is significantly correlated with the side of lower TMT. TMT may serve as an important prognostic marker in patients with CSDH, particularly for predicting functional outcomes.