Comparing twist-drill drainage with burr hole drainage for chronic subdural hematoma

• Main Author: LIN Xin
• Format: Article
• Language: English
• Published: Elsevier 2011-06-01
• Series: Chinese Journal of Traumatology
• Online Access: http://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/86

【Abstract】Objective: The surgical management of chronic subdural hematoma (CSDH) is still a controver- sial issue, and a standard therapy has not been established because of the unclear pathogenic mechanisms in CSDH. The intention of this paper is to find a simple and efficient surgical procedure for CSDH. Methods: A retrospective study of 448 patients with CSDH by surgical treatment during 2005 to 2009 was con- ducted in order to compare the efficiency between two dif- ferent primary surgical methods, i.e. twist-drill drainage with- out irrigation in Group A (n=178) and one burr-hole with irrigation in Group B (n=270). The results were statistically analyzed. Results: The reoperation rates in Group A and Group B were 7.9% and 11.9% respectively. The good outcome rate was 88.8% and 75.5%, the complication was 7.9% and 20.7% in Group A and Group B, respectively. Conclusions: The burr-hole drainage with irrigation of the hematoma cavity is not beneficial to the outcome and prognosis. Irrigation is not important in the surgical treat- ment for CSDH. Thus in initial treatment, twist-drill drainage without irrigation of the hematoma cavity is recommended because it is relatively safe, time-saving and cost-effective. Key words: Hematoma, subdural; Brain injury, chronic; Drainage