Surgical Treatment of Chronic Subdural Hematoma

Ertilav, Kemal; Kocaman, Ümit; Önder, Arif

doi:10.1007/978-3-030-79371-5_29

Cited by 1 publication

(5 citation statements)

References 30 publications

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“…Additionally, we demonstrated that more lateral and more ventral burr hole positions were associated with RrR. Empirically, burr holes were created overlying the hematoma and were mainly on the temporal line, ranging in location from the frontal to the temporal lobe (5). However, there have been no previous studies assessing burr hole positions quantitatively, and the relation between burr hole positions and RrR has remained unknown.…”

Section: Discussionmentioning

confidence: 91%

“…This study has some limitations. We focused on only single burr hole surgery, not other types of surgery, such as two-burr hole surgeries or twist drill surgery (5).…”

Section: Discussionmentioning

confidence: 99%

“…As for the surgical technique, twist drill craniostomy and double burr hole craniostomy may be performed in the management of CSDH (5). However, we think that these operations are considered minor in Japan, and the single burr hole is the surgery of choice for almost all cases of CSDH.…”

Section: Discussionmentioning

confidence: 99%

“…This study has some limitations. We focused on only single burr hole surgery, not other types of surgery, such as two-burr hole surgeries or twist drill surgery (5). Thus, the results of this study can be applied to only single burr hole surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Neurosurgeons frequently encounter chronic subdural hematomas (CSDHs), which occur in approximately 80-120 per 100,000 persons in the aged population (1,2) and are predicted to become the most frequent cranial neurosurgical condition among adults in the future (1,3). Burr hole surgery with a closed drainage system is a simple operation that is effective for CSDH (4)(5)(6)(7)(8)(9)(10). However, neurosurgeons sometimes observe CSDH recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Locations of burr holes are associated with recurrence after single burr hole drainage surgery for chronic subdural hematoma

Hashimoto

Maruo

Ushio

et al. 2022

Preprint

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Objective: The aim of this retrospective single–center study was to quantitatively assess chronic subdural hematomas (CSDHs), reveal the correlations between multiple and quantitative values calculated from computed tomography images, and determine the risk factors for CSDH recurrence. Methods: We enrolled 225 patients who underwent 304 burr-hole surgeries between April 2005 and October 2021 at Otemae Hospital. Patients′ medical records and quantitative values including preoperative CSDH volume (ml), thickness (mm), computed tomography values (CTV), postoperative CSDH volume (ml), and air volume (ml) were evaluated. The locations of CSDH thickness and burr holes were also assessed quantitatively using Montreal Neurological Institute coordinates. Univariate and multivariate regression analyses and receiver operating characteristic (ROC) analyses were performed. Results: Thirty–seven patients (12%) showed CSDH recurrence requiring reoperation. Preoperative CSDH volume was positively correlated with age, preoperative CSDH thickness, CTV, postoperative CSDH volume, and air volume. Univariate Cox proportional hazards regression analysis showed that age, preoperative CSDH volume, Glasgow Coma Scale score (3–14), postoperative hemiplegia, and gait disturbance were risk factors for recurrence requiring reoperation, and a higher CTV (hazard ratio 0.95, 95% confidence interval 0.91–0.99) was associated with a lower risk of recurrence requiring reoperation. Only preoperative CSDH volume was a significant risk factor for recurrence requiring reoperation in multivariate regression analyses. The postoperative air volume and locations of CSDH thickness and burr hole had no influence on recurrence requiring reoperation. ROC curve analysis revealed that the optimal preoperative CSDH volume cut-off value as a predictor was 155 ml, the thickness was approximately 36.3 mm calculated from a regression line. Conclusions: A larger and more hypodense CSDH has a high risk of recurrence requiring reoperation. Residual air volume after surgery and locations of CSDH and burr hole had no influence on recurrence requiring reoperation.

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Section: Discussionmentioning

confidence: 91%

“…This study has some limitations. We focused on only single burr hole surgery, not other types of surgery, such as two-burr hole surgeries or twist drill surgery (5).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%