Effect of Intra-operative Saline Irrigation during Burr Hole Surgery on the Recurrence for Chronic Subdural Hematomas

Objective: The aim of this study is to compare the postoperative recurrence rates and alteration in follow-up brain CT radiographic results between patients with chronic subdural hematoma (CSDH) treated by burr hole trephination with or without irrigation during the surgery. Methods: A total of 100 patients diagnosed with CSDH underwent burr hole trephination from January 2013 to May 2015. The patients were divided into two groups: those who underwent intra-operative saline irrigation and those who did not. Difference in the rate of symptomatic recurrence requiring second surgery between the two groups was evaluated. Radiographic results were analyzed based on the patients’ follow-up brain CTs taken 1 month after the surgery. Results: Sixty eight patients underwent intra-operative irrigation while 32 patients did not. The median ages of the two groups were 69.6 years (range, 39-91 years) and 69.1 years (range, 38-86 years), respectively. Among the “irrigated” group, six patients required second surgery due to recurrent hematoma (8.8%) while nine patients in the “not irrigated” group underwent second surgery (28.1%). Difference in the Glasgow coma scale (GCS) between the two groups had no statistical significance. Conclusion: Upon conducting burr hole trephination surgery for CSDH, saline irrigation is a simple procedure that can reduce the recurrence rate.