Chronic subdural haematoma treated by burr holes and closed system drainage: Personal experience in 131 patients

Abstract

One-hundred and thirty-one patients with chronic subdural haematoma were treated by burr holes and closed system drainage. Four patients died, and in 19 patients postoperative complications were noted: intracranial hypotension in eight, cerebral oedema in four, haematoma recurrence in three, bronchopneumonia in three, and intracerebral haematoma in one. The high risk groups were those in grade III and IV on admission, and the elderly. Follow-up revealed that more than 80% of patients recovered completely, 10% still had neurological or mental deficits and 7% suffered epileptic seizures.

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

“…In the literature, re-intervention rates after burr-hole surgery with subdural drains vary between 8.3 and 26.5 % (5,6,14,19,20,24,35). Results from the present series, and 7.6 % obtained by the akin strategy reported by Gazzeri et al (7), thus represent comparatively low incidences of recurrence.…”

“…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).…”

“…Surgery is generally recommended when chronic subdural hematomas become symptomatic. The optimal surgical procedure, the use of a closeddrainage system, and modalities of post-operative management are under ongoing debate (1,3,9,12,14,25,34,37). Complications of surgery mainly include infection, acute hemorrhage, post-operative seizure, symptomatic hygroma, and symptomatic pneumocephalus (16,22,29).…”

Treatment of chronic subdural hematoma: 5-year clinical experience

“…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.…”

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

“…7,16,19) Burr hole drainage is the most commonly performed treatment modality for evacuation of a CSDH, and is known to be a safe method with a low morbidity rate of 0-9%. However, postoperative complications, including cerebral edema, hematoma re-accumulation, subdural empyema, tension pneumocephalus, and intracranial hemorrhage in other sites, have occasionally been reported.…”