Continuous subgaleal suction drainage for the treatment of chronic subdural haematoma

Abstract

The use of suction assisted evacuation, is followed by results that compare satisfactorily to reports of previous methods, with a low rate of recurrence and complications. It is relatively less invasive and can be used in high risk patients.

Treatment of chronic subdural hematoma: 5-year clinical experience

“…Despite the common practice, the studies by Zumofen et al, Gazzeri et al and Bellut et al indicate the advantages of placement of subperiosteal closed drainage systems regarding rates of hematoma recurrence and serious complications (38)(39)(40). This could especially been shown for elderly patients.…”

“…However, craniotomy is best performed under general anesthesia and is the most invasive option for the treatment of CSDH, encompassing the greatest operative time as well as the greatest volume of the blood loss. Despite the increased risks, craniotomy remains the best option for evacuation of organized, calcified, solid CSDH with numerous thick membranes or the cases with multiple recurrences (5,15,16,(28)(29)(30)39,41,47,52,53).…”

“…Its incidence is reported to be between 1.7 and 13.1 per 100000 inhabitants per year with the highest incidence observed in individuals over 70 (1)(2)(3)(4)(5)(6)(7)(8). There are many operation techniques for CSDH; one or two burr-hole craniostomy with or without saline irrigation and closed system drainage (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21), twist drill craniostomy with or without irrigation and with or without drainage (22)(23)(24)(25)(26)(27), craniotomy and excision of the subdural membranes (28)(29)(30)(31)(32)(33), reservoir shunting for continuous irrigation and drainage (34), percutaneous needle trephination and open system drainage with repeated saline rinsing (35), replacement of the hematoma with oxygen via percutaneous subdural tapping without irrigation and drainage (36,37), continuous subgaleal suction drainage (38)(39)(40). Herewith, we report preliminary results of a retrospective study which compare burr-hole craniostomy with craniotomy.…”

Clinical Analysis of Risk Factors Related to Recurrent Chronic Subdural Hematoma

“…It is generally considered that craniotomy is mandatory if burr hole drainage fails. However, craniotomy has a greater associated morbidity and mortality 3) . We performed repeated burr hole drainage at the previous operation site, which provided good results.…”

Chronic Subdural Hematomas Treated by Burr Hole Trepanation and a Subperiostal Drainage System

“…At present, burr-hole surgery with subdural closed-drainage system is the most commonly chosen strategy. This technique was repeatedly shown to be effective and safe (7,8,14,18,20,22,23,32,34,36,37). More recently, enlarged single-burr-hole trepanation in combination with a suction-assisted subgaleal draining system has also earned consideration as a safe and effective approach (7).…”