Recurrence of the Chronic Subdural Hematoma after Burr-Hole Drainage with or without Intraoperative Saline Irrigation
نویسندگان
چکیده
OBJECTIVE Although standard method has not been established for the chronic subdural hematoma (CSDH), burr-hole trephination and closed system drainage with or without irrigation has been widely accepted as the treatment of choice. The aim of this study is to analysis the post-operative recurrence rates after burr-hole trephination of the CSDH according to the conduction of irrigation. METHODS We retrospectively reviewed 184 patients with CSDH who underwent surgical treatment between January 2009 and December 2013. And 152 patients fulfilled the inclusion criteria as follows: 1) CSDH diagnosed on computed tomography (CT), 2) unilateral hematoma, 3) burr-hole trephination with closed system drainage, and 4) follow-up CT for at least 3 months. Those patients were divided into two groups. Group A (n=38) underwent burr-hole trephination without irrigation, and Group B (n=114), burr-hole trephination with saline irrigation. RESULTS The overall post-operative recurrence rate was 19.1% (n=29) in this study. The majority of recurrence showed in Group B. Twenty-eight patients (24.6%) of Group B had recurrence and only 1 patient (2.6%) of Group A showed recurrence. The recurrence rate was significantly higher in Group B compared with Group A (p=0.003). Another affecting factor for the recurrence was the amount of postoperative pneumocephalus (p=0.02). No catastrophic complications were found in postoperative course. CONCLUSION Although there was no difference of clinical outcome in both groups, the recurrence rate was higher in saline irrigation group compared with no irrigation group. We suggest that saline irrigation procedure be reserved only for selected cases in CSDH burr-hole surgery.
منابع مشابه
Comparison of the Outcomes and Recurrence with Three Surgical Techniques for Chronic Subdural Hematoma: Single, Double Burr Hole, and Double Burr Hole Drainage with Irrigation.
OBJECTIVE Chronic subdural hematoma (CSDH), a disease commonly encountered by neurosurgeons, is treated by burr hole drainage (BHD). However, the optimal surgical technique among the three types of BHD has not been determined. METHODS We conducted a retrospective study on BHD performed on 93 patients who were diagnosed with CSDH. The subjects were divided into three groups based on the surgic...
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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 ...
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