Recurrence factors for chronic subdural hematomas after burr-hole craniostomy and closed system drainage

1999 ◽  
Vol 21 (3) ◽  
pp. 277-280 ◽  
Author(s):  
Katsumi Matsumoto ◽  
Katsuhito Akagi ◽  
Makoto Abekura ◽  
Hideho Ryujin ◽  
Motohisa Ohkawa ◽  
...  
Keyword(s):  
Closed System ◽  
Burr Hole ◽  
Subdural Hematomas

scholarly journals Results of Burr Hole and Open or Closed Suction Drainage for Chronic Subdural Hematomas in Adults

1983 ◽  
Vol 10 (1) ◽  
pp. 22-26 ◽  
Author(s):  
B.K.A. Weir
Keyword(s):  
Closed System ◽  
Burr Hole ◽  
Twist Drill ◽  
Suction Drainage ◽  
Suction Drain ◽  
Subdural Hematomas ◽  
Closed Suction Drainage ◽  
Rubber Catheter ◽  
Drill Holes ◽  
The Brain

SUMMARY:Chronic subdural hematomas in adults are not technically difficult to treat. They probably constitute one of the most common potentially curable lesions with which the average neurosurgeon deals. Despite this (or perhaps because of it) numerous treatments, radically differing from one another, have been advocated. Fine judgement is called for in deciding whether or not to operate in the first instance, make a flap or one or more burr or twist drill holes, use a drain, employ suction, inflate the brain, leave the bone flap out. In a personal series of 71 chronic subdural hematomas, 46 were treated with a red rubber catheter drain through a burr hole and 23 with a closed system suction drain. The results of this series suggest that closed system suction drainage through a single burr hole is the better of the two techniques. It has important theoretical advantages and the procedure is simple and fast. The complication rate is low and patients have a shortened postoperative hospital stay.

scholarly journals Surgical management of chronic subdural hematomas through single-burr hole craniostomy: is it sufficient?

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Omar El Farouk Ahmed ◽  
Ahmad El Sawy ◽  
Shafik El Molla
Keyword(s):  
Clinical Outcome ◽  
Closed System ◽  
Burr Hole ◽  
Altered Level ◽  
Subdural Hematomas ◽  
Elder Patients ◽  
Grade Scale ◽  
Burr Hole Evacuation ◽  
Burr Holes

Abstract Background Symptomatic chronic subdural hematomas (CSDH) remain one of the most encountered forms of intracranial hemorrhages particularly in the elder patients, yet fortunately implies a good surgical prognosis. Burr hole evacuation under general anesthesia is the most commonly used neurosurgical technique for the management of CSDH. Clinical disagreement between many studies regarding the number of burr holes required to achieve the optimal surgical and clinical outcome has long existed. The objective of this study is to evaluate the prognosis and clinical outcome following the use of single-burr hole craniostomy technique in the aim of surgical evacuation of CSDH. Results This is a retrospective study of 30 patients, with symptomatic unilateral or bilateral CSDH managed by the authors strictly by single-burr hole evacuation with closed-system drainage on the corresponding site of the hematoma. Clinical outcome was then assessed at 1, 7, and 30 days after surgery using the Glasgow Coma Scale (GCS) and by comparing the Markwalder grade scale before surgery to 1 month following surgery; the pre- and post-operative radiological data, clinical neurological progress and the possible incidence of complications postoperatively were also recorded. Study duration was from August 2019 to October 2020. Our study included 18 (60%) male patients and 12 (40%) female patients. The main presenting symptom was altered level of consciousness noted in 29 (96.7%) patients; a history of a relevant head trauma was recorded in 11 patients (36.7%). The GCS showed a statistically highly significant improvement comparing the preoperative to the postoperative values throughout the follow-up intervals (p = 0.001); similarly, the Markwalder score significantly improved 1 month after surgery, where 17 (63%) patients were Markwalder grade 0, 9(33.3%) patients were grade 1, a single patient (3.7%) was grade 2, and none were Markwalder grade 3. Conclusion Our study concluded that single-burr hole craniostomy with closed-system drainage for the management of symptomatic CSDH would be a sufficient approach to achieve a good surgical outcome with a low complication rate. Larger series and further studies would be yet considered with longer follow-up periods.

scholarly journals A closed system irrigation & drainage technique for surgical evacuation of chronic subdural haematomas

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 619 ◽  
Author(s):  
Haider Kareem ◽  
Hadie Adams
Keyword(s):  
Length Of Stay ◽  
Closed System ◽  
Chronic Subdural Haematoma ◽  
Burr Hole ◽  
Ageing Population ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
The One ◽  
Irrigation Drainage ◽  
Drainage Technique

Background: Chronic subdural haematoma (CSDH), is a common neurosurgical disorder that is associated with morbidity and mortality affecting the ageing population. The aim is to present the treatment experience of CSDH patients treated with a technique that combines the classical single burr-hole irrigation and the continuous closed system drainage: The closed system irrigation & drainage (CSID) technique. Methods: The cases undergoing CSDH evacuation with the CSID method were captured over a 4-year period at a tertiary neurosurgical centre. The authors describe the performance of this methods with respect to post-operative clinical and radiological features, including recurrence rates, complications, and length of stay. Results: A total of 36 cases undergoing 42 CSID procedures (30 unilateral and 6 bilateral CSDHs) were performed, in cases ranging between 55-95 years old (median age 79 years). The rate of recurrence or significant ruminant blood in the subdural space on post-operative imaging was 11% (n=4). No cases of pneumocephalus were observed in this series (n=0). The mean (SD) skin-to-skin time for this procedure was 13.4 (4.4) minutes, with a mean (SD) length of stay of 4 (1.9) days. Conclusion: We conclude that the one burr-hole closed system irrigation and drainage technique with a sub-periosteal drain seems to be a simple, effective and safe procedure for treatment of CSDH. It’s well tolerated under local anaesthesia for patients with high co-morbidities and these preliminary results indicated it may potentially be a better option for treatment of CSDH with a lower rate of post-operative complications.

Chronic Subdural Hematomas: To Drain or Not to Drain?

Neurosurgery ◽  
1985 ◽  
Vol 16 (2) ◽  
pp. 185-188 ◽  
Author(s):  
Thomas Marc Markwalder ◽  
Rolf W. Seiler
Keyword(s):  
Clinical Improvement ◽  
Closed System ◽  
Subdural Hematoma ◽  
Drainage System ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Postoperative Phase ◽  
Consecutive Series ◽  
Neurological Improvement ◽  
Burr Hole Evacuation

Abstract A consecutive series of 21 adult patients with chronic subdural hematoma was studied in respect to postoperative resolution of subdural collections and clinical improvement after burr hole evacuation without subdural drainage. This series was compared to a previously studied series of patients with chronic subdural hematoma in whom postoperative closed system drainage had been installed. Using the identical protocol for treatment and postoperative follow-up, we obtained identical results with respect to time-related neurological improvement and persistence of subdural collections in the undrained and drained series, except that the steadily progressive clinical improvement during the early postoperative phase (24 hours) in all cases of the drained series was not universal in the undrained cases. Our study suggests that, to avoid the possibility of early postoperative clinical deterioration, burr hole craniostomy and closed system drainage is advisable. We think that subdural drainage is not necessary when the installation of the drainage system seems to be technically difficult, as it may be in cases with considerable perioperative cortical expansion.

Comment on “Single versus double burr hole drainage of chronic subdural hematomas”

2011 ◽  
Vol 18 (3) ◽  
pp. 446-447
Author(s):  
Dimitrios Pahatouridis ◽  
George A. Alexiou ◽  
Spyridon Voulgaris
Keyword(s):  
Burr Hole ◽  
Subdural Hematomas ◽  
Single Versus

scholarly journals Chronic Subdural Hematoma - A Dilemma to Put Drain

2019 ◽  
Vol 9 (1) ◽  
pp. 26-32
Author(s):  
Md Amir Ali ◽  
Md Aminul Islam ◽  
RU Chowdhury ◽  
Ahmed Mursalin ◽  
Md Al Amin Salek ◽  
...  
Keyword(s):  
Closed System ◽  
Subdural Hematoma ◽  
Drainage System ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Chronic Subdural Haematoma ◽  
Burr Hole ◽  
Air Entrapment ◽  
Number Of Patients ◽  
Group A

Background: A chronic subdural hematoma (CSDH) is a collection of blood and blood breakdown products between the surface of the brain and its outermost covering the dura for more than 21 days. The elderly patients are more likely to develop a subdural hematoma, particularly from trivial trauma. CSDHs have been evacuated by burr holes, twist-drill craniotomies and craniotomies. The treatment of chronic subdural haematoma by burr hole drainage has been performed usually without using a closed drainage system, the problem of intracranial air entrapment still persists and can cause a deterioration in the level of consciousness or seizures in the postoperative period. We wanted to compare the effects of patient with drain and those without drain. Objectives: our study is to compare the clinical outcome of CSDH with or without drain. Methods: This prospective study was carried out at CMH Dhaka from January 2017 to July 2018; total 70 cases were investigated for the effectiveness of subdural drain. Cases were randomly allocated in two groups. Data were collected by specially designed questionnaire and analyzed by SPSS. Results and Observation: 70 patients of CSDH were included in this study out of which 25 underwent burr hole with closed system drainage and 45 underwent burr hole without closed system drainage. They were divided into Group A and B, respectively. Among the total number of patients 14 (20%) had shown recurrence. Out of 14 patients, 12 belong to Group B (86 %) and 2 belong to Group a (14 %). Conclusion: It is concluded that, those with a closed system drainage recurrence rate is significantly lower than with burr-hole evacuation alone. Bang. J Neurosurgery 2019; 9(1): 26-32

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