Indian Journal of Neurotrauma 2013; 10(02): 105-108
DOI: 10.1016/j.ijnt.2013.11.004
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Management of chronic subdural haematoma: Single burr-hole drainage and irrigation using the technique of “syringing”

Phani Kumar
,
Uday Kiran

Subject Editor:
Further Information

Publication History

22 June 2013

10 November 2013

Publication Date:
06 April 2017 (online)

Abstract

Background

Chronic subdural haematoma is one of the most common clinical conditions encountered in neurosurgical practice. The surgical approaches exhibit a wide spectrum ranging from simple burr-hole to complex craniotomy with excision of membrane. We tried to approach this condition with a procedure that is safer and faster using a single burr-hole for drainage and a technique of “syringing” the subdural space with normal saline for irrigation.

Aims

We describe our technique of single burr-hole drainage and normal saline irrigation using the technique of “syringing”.

Settings and design

This is a retrospective study wherein we analysed the data of the treated patients contained in the case sheets, operation theatre records and hospital discharge summaries.

Methods and material

Hundred fifty patients who had chronic subdural haematoma were treated surgically from April 2010 to March 2013. All the patients were operated under general anaesthesia. The clinical data at admission, discharge and 3 weeks following discharge was analysed as per the records.

Results

Favourable outcome was seen in all the 150 patients treated. None of the patients had any recurrence. Superficial wound infection was seen in only one patient which subsided with antibiotics.

Conclusions

Single burr-hole drainage and saline irrigation using the technique of “syringing” is a simple, fast and safe procedure for treating chronic subdural haematoma with a favourable outcome.

 
  • References

  • 1 Hamilton M.G., Frizell J.B., Tranmer B.I.. Chronic subdural haematoma reevaluated. Neurosurgery 1993; 33: 67-72
  • 2 Markwalder T.M., Steinsiepe K.F., Rohner M., Reichenbach W., Markwalder H.. The cause of chronic subdural haematoma after burr-hole craniostomy and closed-system drainage. J Neurosurg 1981; 55: 390-396
  • 3 Muratr K.. Chronic subdural haematoma may be preceded by persistent traumatic subdural effusion. Neurol Med Chir (Tokyo) 1993; 33: 691-696
  • 4 Sato S., Suzuki J.. Ultrastructural observations of the capsule of chronic subdural haematoma in various clinical stages. J Neurosurg 1975; 43: 569-578
  • 5 Ito H., Yamamoto S., Komai T., Mizukoshi H.. Role of local hyperfibrinolysis in the etiology of chronic subdural haematoma. J Neurosurg 1976; 45: 26-31
  • 6 Weir B., Gordon P.. Factors affecting coagulation: fibrinolysis in chronic subdural fluid collections. J Neurosurg 1983; 58: 242-245
  • 7 Gurelik M., Aslan A., Gurelik B., Ozum U., Karadag O., Kars H.Z.. A safe and effective method for treatment of chronic subdural haematoma. Can J Neurol Sci 2007; 34: 84-87
  • 8 Santos-Ditto R.A., Santos-Franco J.A., Pinos-Gavilanes M.W., Mora-Benítez H., Saavedra T., Martínez-Gonzáles V.. Management of chronic subdural hematoma with twist-drill craniostomy. Report of 213 patients. Gac Med Mex 2007; 143: 203-208
  • 9 Marwalder T.M.. Chronic subdural haematomas: a review. J Neurosurg 1981; 54: 537-545
  • 10 van Eck A.T., de Langen C.J., Börm W.. Treatment of chronic subdural haematoma with percutaneous needle trephination and open system drainage with repeated saline rinsing. J Clin Neurosci 2002; 09: 573-576
  • 11 Takeda N., Sasaki K., Oikawa A., Aoki N., Hori T.. A new simple therapeutic method for chronic subdural hematoma without irrigation and drainage. Acta Neurochir (Wien) 2006; 148: 541-546
  • 12 Gazzeri R., Galarza M., Neroni M., Canova A., Refice G.M., Esposito S.. Continuous subgaleal suction drainage for the treatment of chronic subdural haematoma. Acta Neurochir (Wien) 2007; 149: 487-493
  • 13 Weigel R., Schmiedek P., Krans J.K.. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatr 2003; 74: 937-943
  • 14 Joon K.L., Jong H.C., Chang H.K., Ho K.L., Jae G.M.. Chronic subdural hematomas: a comparative study of three types of operative procedures. J Korean Neurosurg Soc 2009; 46: 210-214
  • 15 Khadka N.K., Sharma G.R., Roke Y.B.. et al Single burr hole drainage of chronic subdural haematoma. Nepal Med Coll J 2008; 10: 254-257
  • 16 Furukawa T., Gotoh M., Asari S., Ohmoto T., Akioka T.. The relationship between brain surface elastance and brain re-expansion after evacuation of chronic subdural hematoma. Surg Neurol 1996; 45: 570-574