Single versus double burr hole drainage of chronic subdural hematomas. A study of 267 cases

Kansal, Ritesh; Nadkarni, Trimurti; Goel, Atul

doi:10.1016/j.jocn.2009.07.109

Cited by 59 publications

(54 citation statements)

References 20 publications

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“…The rate of recurrence in this study was 6% which is an acceptable one. A similar study reported recurrence rate of 8% -26% [17]. In this study, clinical outcome …”

Section: Discussionsupporting

confidence: 65%

Minimal Access Surgical Evacuation of Unilateral Chronic Subdural Hematoma

Behairy¹

2018

WJNS

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Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions occurring mostly in elderly and ideally treated with surgical drainage. Many surgical techniques of different degrees of invasiveness have been proposed for its treatment with controversy about the best surgical procedure. The study aims to evaluate the efficacy of the minimal access technique of single burr-hole craniostomy and massive irrigation for treatment of unilateral CSDH. The study is a prospective descriptive study involved all patients with symptomatic radiologically proven unilateral CSDH admitted and treated surgically in department of Neurosurgery, Al-Hussein University hospital, Al-Azhar University, Cairo, Egypt, over 3 years, from January 2013 to January 2016. In the results we found that total 64 patients of CSDH, treated surgically by this procedure. Men formed 72% and women 28%. Age range was 51 to 82 years; the mean age was 65 years. Clinical presentation was impaired consciousness in 7%, headache (59%), right hemiparesis in 56% and left hemiparesis in 37%. CT was done for 91% and MRI 27% patients. The hematoma was left in 61% and right in 39%. Surgical evacuation utilizing this procedure was done in all patients. Complete recovery was obtained in 82% of patients and partial recovery in 11% of patients. Follow up for 4 months was done. Recurrence was detected in 6% of patients. We concluded that unilateral CSDH can be treated effectively by single nondependent burr-hole craniostomy and massive irrigation with excellent outcome.

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“…The rate of recurrence in this study was 6% which is an acceptable one. A similar study reported recurrence rate of 8% -26% [17]. In this study, clinical outcome …”

Section: Discussionsupporting

confidence: 65%

Minimal Access Surgical Evacuation of Unilateral Chronic Subdural Hematoma

Behairy¹

2018

WJNS

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“…15 Kansal et al found that mean age of the patient with chronic subdural hematoma was 48 years which is similar to my study. 16 About 50% of patients had GOS 4 at 24 hours. 19 out of 33 patients in GCS group 14 to 15 had favourable outcome at 24 hours.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Glasgow coma scale on admission and clinical outcome of patients with unilateral chronic subdural hematoma after surgery

Islam

Hasan

Das

et al. 2017

Bangabandhu Sheikh Mujib Medical University Journal

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<p>This study was undertaken to determine the influence of Glasgow coma scale (GCS) on admission on clinical outcome of patients with unilateral chronic subdural hematoma after surgery. A cross- sectional study was conducted on 33 consecutive patients, among them 28 were male, 5 were female with GCS 6 to 15. 19 patients out of 22 who had GCS 14-15 had favorable GOS at 24 hours as compared to 2 out of 7 in GCS 9-13 group and none in GCS ≤8 group. All patients (22 out of 22) had favorable GOS at the time of discharge in GCS 14-15 group while 8 out of 9 had favorable GOS in GCS 9-14 group and 1 out of 2 patients had favorable GOS in GCS ≤8 group. Chi square test showed significant difference in outcome between 14-15, 9-13 and ≤8 GCS groups (p values 0.001, 0.015, 0.013 respectively). In conclusion, clinical outcome of patients with unilateral chronic subdural hematoma depends on Glasgow coma scale on admission. </p>

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“…It is characterized by an intracranial hemorrhage with a history of trauma in 50% of patients and occurs predominantly in males and in the elderly 7,10,20,21 . Its incidence has increased considerably due to population aging 21 , reaching 58 patients per 100,000 people in those aged 65 years old or more 4 . Most patients have complete remission of symptoms when diagnosed and treated early 22,23,24 .…”

Section: Discussionmentioning

confidence: 99%

“…Several techniques are described in the literature (burr hole or craniotomy). There is still insufficient scientific evidence to justify the choice of the best technique 20,21,22,23 .…”

Section: Discussionmentioning

confidence: 99%

The number of burr holes and use of a drain do not interfere with surgical results of chronic subdural hematomas

Heringer

Sousa

Oliveira

et al. 2017

Arq. Neuro-Psiquiatr.

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Burr hole evacuation has been the most frequently-used procedure for the treatment of chronic subdural hematomas (CSDH). Objective: To evaluate whether the use of a drain and/or the number of burr holes for treatment of CSDH modifies the rates of recurrence and complications. Methods: A retrospective review of 142 patients operated on because of CSDH, between 2006 and 2015, analyzing recurrence and complications of the use of one or two burr holes with or without the use of a drain. Results: Thirty-seven patients had bilateral CSDH (26%) and 105 (73.9%) patients had unilateral CSDH. Twenty-two (59.4%) patients were given a drain and 15 (40.6%) were not. A total number of recurrences occurred in 22 (15.5%) patients and the total number of complications was in six (4.2%) patients. Mean follow-up time was 7.67 months. Conclusions: The number of burr holes and the use of the drain did not alter the rates of recurrence and complications in the treatment of CSDH.

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Single versus double burr hole drainage of chronic subdural hematomas. A study of 267 cases

Cited by 59 publications

References 20 publications

Minimal Access Surgical Evacuation of Unilateral Chronic Subdural Hematoma

Minimal Access Surgical Evacuation of Unilateral Chronic Subdural Hematoma

Correlation between Glasgow coma scale on admission and clinical outcome of patients with unilateral chronic subdural hematoma after surgery

The number of burr holes and use of a drain do not interfere with surgical results of chronic subdural hematomas

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