TITLE:
Efficacy of Single Burr Hole in Management of Chronic Subdural Hematoma
AUTHORS:
Ahmed M. Elshanawany, Ahmed Elsayed Abokresha, Mohamed Mahmoud
KEYWORDS:
Chronic Subdural Hematoma, Single Burr Hole Evacuation, Complications
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.10 No.1,
December
5,
2019
ABSTRACT: Background: Surgery of chronic subdural hematoma (CSDH) is a common
practice of neurosurgeons. CSDH is considered a pathology of the elderly and
usually many co-morbidities are present. CSDH carries high risk of mortality
if not treated or not treated well. So, the minimal, safe and adequate surgical
intervention is the bases to choose specific surgical maneuver. Aim of the
Study: The efficacy of a single burr in evacuation and treatment of chronic
subdural hematoma. Methods: This study was held in Assiut university hospitals,
neurosurgical department. It is a prospective randomized controlled
study. 113 patients were enrolled in this study in the period between March
2018 and June 2019. We included all cases of chronic subdural hematoma
(CSDH) and subacute subdural hematoma that were evacuated with single
burr hole. Hematomas either, unilateral or bilateral were included. Septated
hematomas were excluded. Patients’ clinical characteristics as age, sex, clinical
presentation, co-morbidities and patients outcome were recorded. Postoperative
status as regards improvement of the neurological status, complications
and recurrence of hematoma were recorded. Results: We had 113 patients
operated via properly situated single burr hole in our study. 113 patients were
included in this study, 79 males (69.9%) and 34 females (30.1%). Age of the
patients ranges between 27 years old and 90 years old. Postoperative follow
up was evaluated according to Glasgow outcome score (GOS). We had 98 patients
with good recovery, 4 patients with moderate disability, 6 patients with
severe disability and 5 patients died. Complications were in form of 3 patients
with residual hematoma, 2 patients with tension pneumocephalus, 7 patients
developed postoperative seizure, 5 cases developed cortical/parenchymal hematoma
and 9 cases developed hematoma recurrence. Conclusion: Single,
properly situated burr hole with previously described characters is an effective
treatment option in cases of CSDH. It helps adequate, effective and safe
removal of the pathology with limited maneuver.