BILATERAL THALAMIC HAEMORRHAGE FOLLOWING BURR HOLE DRAINAGE OF CHRONIC SUBDURAL HEMATOMA

Abstract Chronic subdural hematoma (CSDH), which commonly affects the elderly, is one of the most frequent, but also benign neurosurgical pathologies. Burr hole drainage is the standard surgical modality for evacuation of a CSDH. This technique is known to be safe, with low morbidity and mortality rates. However, postoperative complications have occasionally been reported. We report the case of a 70-year-old man who presented a fatal brain stem hemorrhage after burr-hole drainage for unilateral chronic subdural hematoma. Asymmetrical and rapid decompression were thought to be leading to vascular disruption or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem bleeding. Therefore, a slow rate of evacuation of chronic subdural hematomas, as well as rigorous postoperative reanimation, are recommended in order to prevent serious complications.

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Chronic Subdural Hematomas: To Drain or Not to Drain?

Neurosurgery ◽

10.1227/00006123-198502000-00010 ◽

1985 ◽

Vol 16 (2) ◽

pp. 185-188 ◽

Cited By ~ 76

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.

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Endoscope-assisted single burr hole drainage and irrigation of chronic subdural hematoma (SDH): A retrospective analysis

Journal of Medical Society ◽

10.4103/0972-4958.182910 ◽

2016 ◽

Vol 30 (2) ◽

pp. 103 ◽

Cited By ~ 1

Author(s):

Vyas Khongbantabam ◽

KhaidemMani Singh ◽

Supriya Laifangbam ◽

TakhellambamArun Singh

Keyword(s):

Retrospective Analysis ◽

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Burr Hole

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Predicting Functional Impairment in patients with chronic subdural hematoma treated with burr hole Trepanation—The FIT-score

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2019.05.012 ◽

2019 ◽

Vol 182 ◽

pp. 142-147 ◽

Cited By ~ 1

Author(s):

Nicolai Maldaner ◽

Marketa Sosnova ◽

Johannes Sarnthein ◽

Oliver Bozinov ◽

Luca Regli ◽

...

Keyword(s):

Functional Impairment ◽

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Burr Hole

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Chronic Subdural Hematoma - A Dilemma to Put Drain

Bangladesh Journal of Neurosurgery ◽

10.3329/bjns.v9i1.42921 ◽

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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