Chronic subdural haematomas results of a closed drainage method in adults

Weisse, Allen B.; Berney, J

doi:10.1007/bf01808544

Cited by 26 publications

(26 citation statements)

References 9 publications

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“…One significant technical aspect in BHC-treatment consists in rinsing the haematoma cavity to evacuate possible haematoma clots [3,7,12,19]. Introducing a 5-ram TDT technique with bedside insertion of a special catheter into the haematoma cavity [16], besides adding an even less invasive treatment mode, also changed the previous usual practice of additional rinsing by simply evacuating it slowly.…”

Section: Discussionmentioning

confidence: 98%

Chronic subdural haematoma ? a comparison of two different treatment modalities

1997

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Burr-hole craniotomy (BHC) and closed-system drainage undoubtedly is currently the most accepted treatment offered in chronic subdural haematoma (CSDH). Although twist-drill trephination (TDT) techniques have been available for years, now a special subdural catheter kit has been launched for treatment of CSDH. In a prospective study, 33 patients with 36 CSDH were treated with a 5-mm TDT regimen and insertion of a CORDIS subdural catheter (CORDIS Corp., Miami, USA). The results are compared with a consecutive series of 33 patients treated previously with an 11-mm BHC and closed-system drainage for 40 CSDH: Recurrence and persistence rate of CSDH treated with TDT necessitating a second intervention was 18.1%, no further surgical intervention was necessary. In BHC treated patients, 33.3% of haematomas had to be reoperated on, another 6.0% had to be re-operated on a third time. Infection rate in BHC treated patients was 18.1% as compared with a 0% infection rate in patients treated with the TDT technique. Mortality rate for the BHC method was 9.0% as compared with 6.0% in the TDT treatment regimen. Significantly better clinical results are achieved using the TDT technique with insertion of a special subdural catheter, making this procedure superior to the BHC regimen.

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Section: Discussionmentioning

confidence: 98%

Chronic subdural haematoma ? a comparison of two different treatment modalities

1997

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“…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).…”

Section: Introductionmentioning

confidence: 99%

“…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).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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OBJECTIVE Most symptomatic chronic subdural hematomas are treated by subdural drainage. However, a subperiostal (i.e., extracranial) passive closed-drainage system in combination with double burr hole trepanation is used at our institution. Therefore, we wanted to analyze our results and compare them with the alternate treatment strategies reported in the current literature. METHODS In a retrospective single-center study, we analyzed the data of all patients undergoing double burr hole trepanation with a subperiostal passive closed-drainage system. Data analysis included general patient data, complications, postoperative seizure rate, and outcome. RESULTS One hundred forty-seven patients underwent surgery for 183 symptomatic chronic subdural hematomas. The perioperative mortality rate was 3.4%. Hematoma persistence or recurrence occurred in 13.1% of the cases. The postoperative seizure rate was 6.6%, and the infection rate was 1.6%, including 3 cases of superficial wound infection and 1 case with deep infection. The reintervention rate was 9.3%, including trepanation in 8.2% of the patients and craniotomy in 1.1%. The overall complication rate was 10.9%. CONCLUSION Double burr hole trepanation combined with a subperiostal passive closed-drainage system is a technically easy, highly effective, safe, and cost-efficient treatment strategy for symptomatic chronic subdural hematomas. The absence of a drain in direct contact with the hematoma capsule may moderate the risk of postoperative seizure and limit the secondary spread of infection to intracranial compartments.

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“…We observed 14.2% of recurrences; they were mainly observed in mixt and hyperdense lesions. Recurrences seemed to be in relation with the preoperative density of the lesion and consequently with the inflammatory status of the hematoma as observed by some authors (4,5,(76)(77)(78). Overall results of the present series were in total concordance with those of large series of the literature (6,10,12,15,16,27,35,36,43,(59)(60)(61)67,79,80).…”

Section: Discussionmentioning

confidence: 64%

Open Drainage in Chronic Subdural Hematomas: A Prospective Study of 189 Cases

Bakhti

Tighilt

Djennas

2016

IrJNS

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Background & Importance: Chronic subdural hematoma (CSH) is one of the most frequent intracranial hemorrhages in adults. However, gold standard treatment of CSH is not yet defined. Since the 80's, closed drainage is a standard among techniques using drains because the open type has been incriminated in high rates of postoperative infections. However, closed drainage requires materiel which is sometimes not available or expensive in some countries. Open drainage was reintroduced in our department in the middle of the 90's because of economic crisis at this time. We have then conducted a prospective study to assess safety and efficacy of open drainage in treatment of CSH.Case Presentation: A prospective study of adult patients with CSH was conducted from January 2008 to December 2011. All patients have the same surgical procedure which included one burr-hole craniostomy, spontaneous evacuation and open drainage. The study focused on infectious complications, postoperative seizures, and recurrences. Results are compared with those of literature. In our study, 189 patients were operated with mean age of 69.2 years old. Of all, 163 patients were cured. Overall rate of complications was 15.34% with an infection rate of 1.58%, a postoperative seizure rate of 1.05% and a recurrence rate of 14.2%. Mortality rate was 5.8%. Results were in concordance with those of large series of literature. Conclusion:Data of the current study suggested that open drainage is a safe and efficient method in treatment of CSH. It is also a costefficient treatment that could be very interesting for middle-and low-income countries. Keywords AbstractBackground and Importance

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Chronic subdural haematomas results of a closed drainage method in adults

Cited by 26 publications

References 9 publications

Chronic subdural haematoma ? a comparison of two different treatment modalities

Chronic subdural haematoma ? a comparison of two different treatment modalities

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

Open Drainage in Chronic Subdural Hematomas: A Prospective Study of 189 Cases

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