Burr Hole Surgery for Drainage of Chronic and Subacute Subdural Hematomas: Low Recurrence Rate in a Single Surgeon Cohort

Jesús, Orlando De; Monserrate, Andres E.

doi:10.7759/cureus.19288

Cited by 2 publications

(2 citation statements)

References 23 publications

(31 reference statements)

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“…Surgical intervention, particularly the drainage of chronic and subacute subdural hematomas via burr holes, has been associated with a low recurrence rate in long-term studies [ 11 ]. In the specific context of our patient, bilateral frontal/parietal burr holes were drilled for drainage, complemented by bilateral drain insertion to mitigate the recurrence risk.…”

Section: Discussionmentioning

confidence: 99%

Navigating the Challenges of Delayed Subdural Hemorrhage and COVID-19: A Case Report

Al Qahtani,

Alfaraj,

Alzayer

et al. 2024

Cureus

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The delayed onset of posttraumatic subdural hemorrhage (SDH) represents non-specific clinical features, complicating the diagnostic process, especially in individuals predisposed due to pre-existing risk factors and comorbidities. This case report delineates the medical trajectory of a 61-year-old female patient who sustained a traumatic fall, initially displaying neither clinical nor radiological signs indicative of hemorrhage. However, three weeks post-injury, she developed altered mental status, cephalgia, and emesis. Diagnostic imaging unveiled a significant bilateral acute-on-chronic subdural hemorrhage exerting pronounced mass effect and leading to obliteration of the basal cisterns. Complicating her clinical picture was a concurrent SARS-CoV-2 infection and a medical history of hypertension. Emergent neurosurgical intervention was undertaken, encompassing the creation of bilateral burr holes for drainage and the placement of subdural drains. The patient was managed with the requisite medical therapies. Post-operatively, the patient regained consciousness and exhibited significant neurological improvement. Follow-up imaging demonstrated complete resolution of the subdural hemorrhage, and the patient achieved a full recovery of cognitive function. This case underscores the critical necessity for vigilant surveillance for delayed SDH in patients lacking initial radiographic findings and advocates for individualized therapeutic approaches in patients with concurrent pathologies. Prompt recognition, timely neurosurgical management, and care are pivotal to optimizing outcomes in delayed posttraumatic SDH cases.

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Section: Discussionmentioning

confidence: 99%

Navigating the Challenges of Delayed Subdural Hemorrhage and COVID-19: A Case Report

Al Qahtani,

Alfaraj,

Alzayer

et al. 2024

Cureus

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“…Recurrence is a major problem in patients with CSDH, and recurrence rates of up to 33% have been reported (7). In the last 20 years, postoperative drain insertion in the cavity after BHC has becomea widely used method owing to its reduction of the risk of recurrence (8,40,42,45). Several studies have investigated the factors that contribute to the recurrence of CSDH.…”

Section: Achmed Alimentioning

confidence: 99%

A comparison of subgaleal active drainage and subdural passive drainage and an analysis of factors affecting chronic subdural hematoma outcomes

Özgen¹,

Dolaş²,

Ünal³

et al. 2022

Turkish Neurosurgery

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AIM:To analyze and to compare the factors that influence the recurrence of chronic subdural hematoma (CSDH) among patients treated with subdural non-suction-assisted passive drainage, subgaleal suction-assisted active drainage, and without drainage. MATERIAL and METHODS:We retrospectively evaluated 87 surgical patients with a diagnosis of CSDH treated between 2007 and 2018 using patient records from the neurosurgery archive of our faculty. The patients were divided into three groups: drainfree group (group A), subdural passive drainage group (group B), and subgaleal active drainage group (group C). Recurrence was defined as an increase in hematoma volume on imaging and persistence of the patient's symptoms. RESULTS:Patients with double-membrane CSDH exhibited higher recurrence rates (p=0.043) and those with low-density CSDH exhibited lower recurrence rates (p=0.015) compared to the other patients. No relationship was found between the number of burr holes made and CSDH recurrence (p=0.177). Group C showed the lowest recurrence rate (13.3%), but the differences between groups were not statistically significant.CONCLUSION: Hematoma density, membrane type, postoperative Glasgow Outcome Scale scores, and postoperative drainage time were found to be statistically significant predictors of recurrence. Burr-hole craniotomy with subgaleal active drainage is a safe and effective method for preventing CSDH recurrence and carries a reduced risk of parenchymal injury.

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Burr Hole Surgery for Drainage of Chronic and Subacute Subdural Hematomas: Low Recurrence Rate in a Single Surgeon Cohort

Cited by 2 publications

References 23 publications

Navigating the Challenges of Delayed Subdural Hemorrhage and COVID-19: A Case Report

Navigating the Challenges of Delayed Subdural Hemorrhage and COVID-19: A Case Report

A comparison of subgaleal active drainage and subdural passive drainage and an analysis of factors affecting chronic subdural hematoma outcomes

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