Surgical Management of Chronic Subdural Hematoma: Number of Burr Holes in Relation to Rate of Recurrence and Complications

Abstract

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.