Single versus double burr-hole drainage for chronic subdural hematoma: A study of relevant prognostic factors conducted in Pakistan

Abstract

Objective: To compare the efficacy of single versus double burr-hole for drainage of chronic subdural hematoma, keeping in consideration pertinent demographic, pre and postoperative associations.
 Methods: A prospective cohort study carried out in Combined Military Hospital, Multan, (December 2016-August 2018), on adults with diagnosed chronic subdural hematoma (CSDH); being segregated by randomized control trial, non-probability purposive sampling into Group-A and Group-B (who underwent single and double burr-holes for CSDH-drainage respectively). Utilizing SPSS-21, data expressed as frequencies/percentages and mean± standard deviation (SD) and cross-tabulated; p-value <0.05 was taken as significant.
 Results: Age and GCS scores were 62±13.694 (range 38-94) and 11.00±3.350 (range 3-15) respectively, males being 40(66.7). Post-operative fatality was Nil, while 8(13.3%) and 14(23.3%) had post-operative seizures and recurrence of hematoma respectively. There was no significant association between type of burr-hole and hospital stay (p 0-884), seizures (p 0.448) or recurrence (p 0.542). Hospital stay (p<0.000) and seizures (p-0.005) were inversely proportional to GCS scores on presentation. Recurrence rates were not affected by age (p-0 .175) or gender (p-0 .281).
 Conclusion: There was no significant difference between outcomes of single and double burr-hole surgeries; the former must be preferred because of lesser iatrogenic trauma. GCS-score on presentation was validated as a negative association to anticipate post-operative outcomes.
 doi: https://doi.org/10.12669/pjms.35.4.543
 How to cite this:Khan HU, Atif K, Boghsani GT. Single versus double burr-hole drainage for chronic subdural hematoma: A study of relevant prognostic factors conducted in Pakistan. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.543
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Surgery is currently the common clinical treatment for CSDH, including single hole drainage, double borehole drainage and minimally invasive puncture drainage, but clinical practice shows that borehole drainage will cause severe trauma, which is difficult to meet the increasing needs of patients. 5 , 6 …”

Hemoglobin Concentration May Affect the Effect of Atorvastin on Chronic Subdural Hematoma After Burr-Hole Drainage at High Altitude

“…Chronic subdural hematoma (CSDH) is a common and frequently occurring disease, and the incidence rises with age (Sahyouni et al, 2017). Burr-hole drainage is a routine operation for the treatment of CSDH (Tang et al, 2018;Soleman et al, 2019;Khan et al, 2019), but the recurrence rate is ∼10-39% (Kim et al, 2014;Jang et al, 2015). Local inflammatory responses may contribute to the recurrence of CSDH (Jaiswal and Sontakke, 2012;Zhang et al, 2020).…”