Background: Chronic subdural hematoma (CSDH) is a common problem encountered in daily practice in neurosurgery departments worldwide. It is defined as abnormal collection of blood or blood product in the subdural space with an indolent course. The recurrence rate of CSDH ranges from 2% to 37%. Aim of Study:We tried to find if there a significance of the number of burr-holes in surgical evacuation of CSDH in relation to the rate of recurrence or the rate of complications. Patients and Methods:This a prospective interventional study conducted over 32 patients with chronic subdural hematoma treated between January 2018 and January 2021. The patients were divided into 2 groups, 16 patients were operated by single burr-hole craniostomy (SBHC), and the other 16 patients were operated by double burr-hole craniostomy (DBHC). Recurrence was considered if there is need for re-evacuation of the hematoma surgically.Results: Group A: This group included 16 patients operated by 2 burr holes. The only reported surgical complication in this group was superficial wound infection in 2 cases (12.5%). Recurrence was reported in one case only (6.3%). Group B: This group included 16 patients operated by single burr hole. Regarding the surgical complications: Superficial wound infection was reported in one case (6.3%) and incomplete evacuation in one case (6.3%). Recurrence was reported in 2 cases (12.5%). Conclusion:In our study, we found that the patients with CSDH operated upon by SBHC had higher rate of recurrence than those operated by DBHC, although it was not statistically significant (p>0.05). There is no statistical significance regarding the rate of complication between both techniques. We conclude that surgical management of CSDH with SBHC is safe and efficient as DBHC.

Background: Surgery of chronic subdural hematoma (CSDH) is a common practice of neurosurgeons. CSDH is considered a pathology of the elderly and usually many co-morbidities are present. CSDH carries high risk of mortality if not treated or not treated well. So, the minimal, safe and adequate surgical intervention is the bases to choose specific surgical maneuver. Aim of the Study: The efficacy of a single burr in evacuation and treatment of chronic subdural hematoma. Methods: This study was held in Assiut university hospitals, neurosurgical department. It is a prospective randomized controlled study. 113 patients were enrolled in this study in the period between March 2018 and June 2019. We included all cases of chronic subdural hematoma (CSDH) and subacute subdural hematoma that were evacuated with single burr hole. Hematomas either, unilateral or bilateral were included. Septated hematomas were excluded. Patients' clinical characteristics as age, sex, clinical presentation, co-morbidities and patients outcome were recorded. Postoperative status as regards improvement of the neurological status, complications and recurrence of hematoma were recorded. Results: We had 113 patients operated via properly situated single burr hole in our study. 113 patients were included in this study, 79 males (69.9%) and 34 females (30.1%). Age of the patients ranges between 27 years old and 90 years old. Postoperative follow up was evaluated according to Glasgow outcome score (GOS). We had 98 patients with good recovery, 4 patients with moderate disability, 6 patients with severe disability and 5 patients died. Complications were in form of 3 patients with residual hematoma, 2 patients with tension pneumocephalus, 7 patients developed postoperative seizure, 5 cases developed cortical/parenchymal hematoma and 9 cases developed hematoma recurrence. Conclusion: Single, properly situated burr hole with previously described characters is an effective treatment option in cases of CSDH. It helps adequate, effective and safe removal of the pathology with limited maneuver.