scholarly journals Unilateral drainage of bilateral chronic subdural hematoma

2021 ◽  
Vol 11 (6) ◽  
pp. 155-158
Author(s):  
Allan J Drapkin ◽  
Manuel Campos P
Keyword(s):  
Head Trauma ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Optimal Treatment ◽  
Burr Hole ◽  
Course Of Action ◽  
Burr Hole Evacuation ◽  
Bilateral Chronic Subdural Hematoma

Bilateral chronic subdural hematoma (bCSDH) is a condition frequently encountered in neurosurgical practice, and it is usually the result of head trauma. Despite its frequency, no consensus currently exists regarding its optimal treatment. While the use of corticosteroids in the treatment of chronic subdural hematoma is not currently accepted by the neurosurgical community, there is enough evidence in the literature that supports its use. In bCSDH the unilateral burr hole evacuation of the larger of the subdural collections followed by a course of corticosteroids seems to be an effective and safer course of action in the management of bilateral chronic subdural hematoma.

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.

scholarly journals Bilateral Chronic Subdural Hematoma in the Posterior Fossa Treated with a Burr Hole Irrigation: A Case Report and Review of the Literature

2019 ◽  
Vol 11 (1) ◽  
pp. 87-93
Author(s):  
Takuro Inoue ◽  
Hisao Hirai ◽  
Ayako Shima ◽  
Fumio Suzuki ◽  
Masayuki Matsuda
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Posterior Fossa ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Ventricular Drainage ◽  
Review Of The Literature ◽  
Bilateral Chronic Subdural Hematoma ◽  
Radiological Examinations

Chronic subdural hematoma (CSH) in the posterior fossa is extremely rare. The surgical strategy is still controversial. We report a case of bilateral CSH in the posterior fossa successfully treated with a single-burr hole surgery. A 74-year-old man under anticoagulation and antiplatelet therapy developed headache and nausea during observation for an asymptomatic supratentorial CSH. Radiological examinations revealed appearance of bilateral CSH in the posterior fossa associated with hydrocephalus. Upon rapid deterioration of the patient’s consciousness, an urgent treatment was required. A burr hole was made near the transverse-sigmoid junction on the left side to access the hematoma. No ventricular drainage was placed as his consciousness improved during the decompression of the hematoma. Postoperative computed tomography showed that bilateral CSH and hydrocephalus had been successfully treated. In bilateral CSH in the posterior fossa, there may be a connection between each side. CSH in the posterior fossa, when urgent, can be treated under local anesthesia with a unilateral burr hole irrigation.

A prospective randomized study of use of drain versus no drain after burr-hole evacuation of chronic subdural hematoma

2014 ◽  
Vol 62 (2) ◽  
pp. 169 ◽  
Author(s):  
Bhaskar Suryanarayanan ◽  
Ajay Choudhary ◽  
LaxmiNarayan Gupta ◽  
Akhila Prasad ◽  
AmitKumar Singh ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Randomized Study ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Prospective Randomized Study ◽  
Burr Hole Evacuation

scholarly journals Outcome of Chronic Subdural Hematoma Treated with Single Burr Hole Under Local Anesthesia

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Abebe Mersha ◽  
Sahlu Abat ◽  
Tsegaye Temesgen ◽  
Abebe Nebyou
Keyword(s):  
Hospital Stay ◽  
Local Anesthesia ◽  
Subdural Hematoma ◽  
Addis Ababa ◽  
Chronic Subdural Hematoma ◽  
Postoperative Outcome ◽  
The Elderly ◽  
Burr Hole ◽  
Cross Sectional ◽  
Burr Hole Evacuation

BACKGROUND: Chronic subdural hematoma (CSDH) is a common condition encountered in daily neurosurgical practice usually affecting the elderly population. Various surgical procedures have been used for the evacuation of hematoma in patients with CSDH. The objective of this paper was to study the postoperative outcome of patients who were operated for CSDH and to describe the easy, safest and effective procedure that can be performed at primary level hospitals.METHODS: Institutional based cross-sectional retrospective study was conducted among patients operated for CSDH from January 1, 2012 to December 31, 2015 at Teklehaymanot General Hospital, a private hospital in Addis Ababa, Ethiopia. Descriptive statistics, using SPSS version 20, was used to determine the postoperative outcomes including hospital stay, complications and recurrence rate.RESULTS: Of the 195 charts reviewed, 70.3% were of males, with M: F ratio of 2.4:1. 68.2% of patients being above the age of 55 years with a mean age at presentation of 57.63. The most common presenting symptom was headache followed by extremity weakness. The diagnosis of CSDH was made with either head CT scan or MRI. Forty one percent of patients had a left side hematoma and 48(24.6%) patients had bilateral CSDH. All patients were operated with a single burr hole evacuation under local anesthesia and postoperative subdural closed system drainage by a single neurosurgeon. The mean hospital stay was 3.68±2.6 days. The postoperative outcome was assessed using the Glasgow Outcome Score, and 95.9% of the patients reported good recovery. Thirteen (6.6%) patients were operated twice for recurrence, and there were four deaths.CONCLUSIONS: Single burr hole craniostomy is an easy, safe and effective technique for the treatment of CSDH.

scholarly journals Neuroendoscopic Approach of a Massive Bilateral Chronic Subdural Hematoma in a Child Using a Single Burr Hole

Cureus ◽  
2021 ◽  
Author(s):  
Leopoldo Mandic Ferreira Furtado ◽  
José Aloysio Da Costa Val Filho ◽  
Camila Moura de Sousa ◽  
François Dantas ◽  
Júlia da Silva Costa
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Bilateral Chronic Subdural Hematoma

scholarly journals Organized Subdural Hematoma with Thick Membrane in Chronic Subdural Hematoma

2012 ◽  
Vol 52 (185) ◽  
Author(s):  
P Shrestha ◽  
B Panta ◽  
P Shrestha ◽  
P Rajbhandari
Keyword(s):  
Subdural Hematoma ◽  
Analytical Study ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Membrane Formation ◽  
Burr Hole Evacuation

Introduction: Chronic subdural hematoma (CSDH) may occasionally contain organized hematoma which can lead to recurrence and other complications after surgery. There is no exact study and data about OHTMF in Nepal so far. The main objective of this study is to study its prevalence and complications. Methods: This is a multicentric retrospective analytical study being carried out at Norvic International Hospital and Annapurna Neurological Institute. We retrospectively analyzed one hundred cases of CSDH between early 2006 to 2010 August. We focused our study mainly on OHTMF. Results: Of 100 cases, majority of the patients were male ranging from 4 to 85 years of age. Bilateral subdural hematoma was found in about 9% of cases. Majority of cases were treated in usual fashion with single burr hole and drain. OHTMF was found in 3 cases (3%) for which craniotomy with radical membranectomy was performed. In 2 cases membrane formation was noticed during surgery, craniotomy with total membranectomy was performed immediately. In one case there was recurrence of CSDH within 10 days of single burr hole evacuation. Craniotomy with membranectomy was performed in 2nd surgery. There was no recurrence after membranectomy. One case developed seizure post operatively. Conclusions: OHTMF is one of the important causes of CSDH recurrence. It has to be treated radically. Different hypthotheses have been postulated regarding thick membrane formation in CSDH. We have tried to discuss these hypotheses. Keywords: burr hole evacuation, craniotomy, CSDH, OHTMF.

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