Burr-Hole Craniostomy with T-Tube Drainage as Surgical Treatment for Chronic Subdural Hematoma

Lu, Wenchao; Wang, Hui; Wu, Tao; Sheng, Xudong; Ding, Zhi-Bin; Xu, Gaoran

doi:10.1016/j.wneu.2018.04.168

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…This method may be reserved for refractory or cases of at least three times recurrence. There are some modified techniques such as implantation of a reservoir [76], continuous subgaleal suction drainage [24], or a T-tube drainage [51]. Although they may reduce additional operations [43], these modifications failed to get popularity.…”

Section: Alternative Methodsmentioning

confidence: 99%

How to Treat Chronic Subdural Hematoma? Past and Now

Lee

2019

J Korean Neurosurg Soc

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Treatment of chronic subdural hematoma (CSDH) is relatively straightforward, however, there is still some debate regarding the best strategy for treatment. The most practical recommendations of up to date were identified by a review of literature. The author reviewed the literature on CSDH management from the past to now to identify the best methods. Till 1970s, craniotomy was the most commonly used method. Burr hole (BH) became the most preferred method from 1980s. In 1977, twist drill (TD) craniostomy was introduced. Closed system drainage after a BH or a TD became the most frequently used surgical method. Although nonsurgical treatment is often successful, trephination has more advantages, such as rapid resolution of the symptoms and short period of hospitalization. Nonsurgical treatment is possible in asymptomatic patients with a small CSDH. For the symptomatic patients with CSDH, trephination is the treatment of choice, either by BH or TD. In gray zone between surgery and medical treatment, shared decision making can be an ideal approach. For the recurrent CSDHs, repeated trephination is still effective for patients with a low risk of recurrence. If the risk of recurrence is high, additional management would be helpful. For the refractory CSDHs, it is necessary to obliterate the subdural space.

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Section: Alternative Methodsmentioning

confidence: 99%

How to Treat Chronic Subdural Hematoma? Past and Now

Lee

2019

J Korean Neurosurg Soc

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“…Very recently, preliminary recommendations were suggested for use during a neurosurgery operation on Covid-19 infected patients. 7 Thus, there are multiple treatment options 20,[27][28][29][30][31][32][33] and there is no consensus on the way a neurosurgeon decides how to best treat their patient with CSDH. The aim of this article was to elaborate a protocol with effective and minimally invasive techniques to be performed in the complex and fragile patient with both CSDH and Covid-19, with the dual intention of protecting the surgeon from SARS-CoV-2 infection and optimizing the patient's chance of being healed.…”

Section: Introductionmentioning

confidence: 99%

Guidance for chronic subdural hematoma surgery in the novel coronavirus pandemic (Covid-19)

Valênça¹,

Valença

Martins

et al. 2021

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Of great concern to the neurosurgical community is this novel coronavirus pandemic 2019, a result of dissemination to all continents of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Without proper care, there is a very high chance of being infected by the lethal SARS-CoV-2 during a routine neurosurgical procedure. SARS-CoV-2 infected a significant part of the healthcare workers, including neurosurgeons, responsible for direct care for patients with Covid-19, and several of those infected have already died. Drastic modifications should be made in the process the operating room is prepared, and in the attitudes taken by medical personnel in an attempt to minimize a possible contact of the SARS-CoV-2. The novel coronavirus is present not only in the respiratory tract, but the virus may also be encountered in blood, stool, and CSF. In this article, the authors want to address the topic of how the neurosurgeons can mitigate the chance of being infected with SARS-CoV-2 during a surgical procedure performed on a patient with Covid-19. For this, we chose a common condition in neurosurgery practice - and one of the simplest in its execution - the chronic subdural hematoma (CSDH). There is still no consensus on how to operate patients with CSDH. This article aimed to elaborate a protocol with effective and minimally invasive techniques to be performed in the patient with both CSDH and Covid-19, with the dual intention of protecting the surgeon from SARS-CoV-2 infection and optimizing the patient's chance of healing.

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“…But the impact of factors on the therapeutic outcomes of CSDH is also still unknown. However, most of the published literatures focus either on the therapies of CSDH (Lu et al, 2018; Srivastava et al, 2018; Xu et al, 2018; Yuan et al, 2018) or on rare case reports (Mikkelsen et al, 2017; Tempaku, 2017; Ichinose et al, 2018; Wang and Yu, 2018), especially in Chinese studies. Hence, a high quality retrospective study on Chinese CSDH patients is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Effect of Different Factors on the Short-Term Outcome of Chinese Patients With Primary Chronic Subdural Hematoma at Different Age Groups: A Two-Center Retrospective Study

Huang

Tian

Song

et al. 2019

Front. Aging Neurosci.

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BackgroundThe incidence of symptomatic chronic subdural hematoma (CSDH) is increasing in Chinese aging population, but its clinical and demographic knowledge is still lacking. This study sought to outline the clinical and demographic data of CSDH patients from two medical centers in Tianjin and Chongqing to provide a better understanding for CSDH treatment in China.MethodsAge, sex, etiologies, conscious level on admission, treatment strategies, outcome at discharge, recurrence, and concomitant disease of enrolled patients were recorded. The data were further analyzed after the patients were sub-grouped into young/middle (less than 60 years old) and old (over than 60 years old) age groups.ResultsA total of 1281 CSDH patients were enrolled. Of these, 85.01% were male and 51.91% were aged between 60 and 80 years. 57.61% patients encountered head trauma before diagnosing CSDH. The top three clinical symptoms at admission were headache (58.55%), dyskinesia (36.92%), and dizziness (33.96%). Headache as well as dizziness often happened in young/middle age group, while dyskinesia often occurred in the old age group. The most common concomitant diseases were cardio-cerebrovascular system diseases (41.14%). The concomitant respiratory diseases in aged patients led to unfavorable outcomes (p = 0.049, OR:0.357). The prognosis of old age subgroup receiving conservative treatment was better than those who received burr-hole drainage treatment (p < 0.015, OR:4.091).ConclusionCSDH mostly occurs in aged and male population with a history a head trauma. The respiratory disease often results in unfavorable outcomes in aged patients. Conservative treatment might benefit some patients.

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Burr-Hole Craniostomy with T-Tube Drainage as Surgical Treatment for Chronic Subdural Hematoma

Cited by 5 publications

References 22 publications

How to Treat Chronic Subdural Hematoma? Past and Now

How to Treat Chronic Subdural Hematoma? Past and Now

Guidance for chronic subdural hematoma surgery in the novel coronavirus pandemic (Covid-19)

Effect of Different Factors on the Short-Term Outcome of Chinese Patients With Primary Chronic Subdural Hematoma at Different Age Groups: A Two-Center Retrospective Study

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