Comparison of the Outcomes and Recurrence with Three Surgical Techniques for Chronic Subdural Hematoma: Single, Double Burr Hole, and Double Burr Hole Drainage with Irrigation.
10.13004/kjnt.2015.11.2.75
- Author:
Kyoung Min JANG
1
;
Jeong Taik KWON
;
Sung Nam HWANG
;
Yong Sook PARK
;
Taek Kyun NAM
Author Information
1. Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea. jtkwon@cau.ac.kr
- Publication Type:Original Article
- Keywords:
Hematoma, subdural, chronic;
Trephining;
Drainage;
Therapeutic irrigation
- MeSH:
Drainage*;
Hematoma;
Hematoma, Subdural, Chronic*;
Humans;
Recurrence*;
Retrospective Studies;
Therapeutic Irrigation;
Trephining
- From:Korean Journal of Neurotrauma
2015;11(2):75-80
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Chronic subdural hematoma (CSDH), a disease commonly encountered by neurosurgeons, is treated by burr hole drainage (BHD). However, the optimal surgical technique among the three types of BHD has not been determined. METHODS: We conducted a retrospective study on BHD performed on 93 patients who were diagnosed with CSDH. The subjects were divided into three groups based on the surgical technique performed: single BHD without irrigation (Group A, n=31), double BHD without irrigation (Group B, n=32), and double BHD with irrigation (Group C, n=30). The clinical factors, radiological factors and recurrences were compared between the three groups. Moreover, independent factors affecting the recurrence were analyzed. RESULTS: The change in hematoma thickness was 29.77+/-7.94%, 49.73+/-12.87%, and 75.29+/-4.32% for Group A, B, and C, respectively, while the change in midline shift was 40.81+/-15.47%, 51.78+/-10.94%, and 56.16+/-16.16%, respectively. Thus, Group C showed the most effective for resolution of hematoma and midline shift (p<0.05). Group A, B, and C had 12 cases (38.7%), 8 cases (25.0%), and 3 cases (10.0%) of recurrences, respectively. Group C had a statistically significantly fewer recurrence rate than Group A (p<0.05). Double burr hole, irrigation, and coagulopathy were each identified as independent factors that reduce recurrence (p<0.05). CONCLUSION: Among the three techniques, the double BHD with saline irrigation resulted in the fewest recurrences. It is probably the most effective technique for preventing the recurrence of CSDH.
