[Chronic subdural hematoma. Surgical management in 100 patients]
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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Edna Sikahall-Meneses1, Natalia Salazar-Pérez, Bayron Sandoval-Bonilla
1Servicio de Neurocirugía, Hospital de Traumatología Dr. Victorio de la Fuente Narváez, Unidad Médica de Alta Especialidad Magdalena de las Salinas, Instituto Mexicano del Seguro Social, México, D.F., Mexico. edna3065@yahoo.com.mx
Insights
This study analyzed 100 chronic subdural hematoma (CSH) cases, finding burr hole drainage effective for most frontoparietal hematomas. While some complications occurred, overall mortality was low, suggesting appropriate surgical selection improves outcomes.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Context:
- Chronic subdural hematoma (CSH) is a common intracranial hemorrhage requiring careful management.
- Treatment decisions for CSH can be challenging due to variations in institutional practices and borderline features.
- Prognosis is directly linked to the selection of the appropriate surgical procedure.
Purpose:
- To analyze surgical outcomes in 100 patients with chronic subdural hematoma (CSH).
- To evaluate the effectiveness of burr hole drainage versus craniotomy for CSH.
- To identify factors influencing surgical results and complications in CSH management.
Summary:
- The study included 100 patients diagnosed with CSH, predominantly with frontoparietal locations.
- Burr hole drainage was the primary surgical approach in most cases.
- Incomplete drainage occurred in 18% of cases, necessitating reoperation, and pneumocephalus was observed in 11%.
Impact:
- The study reports a 2% mortality rate for CSH, which is lower than previously documented.
- Appropriate surgical selection, particularly burr hole drainage, appears to contribute to favorable outcomes in CSH.
- Findings provide insights into managing CSH and optimizing surgical strategies to reduce complications and mortality.
Abstract:
Chronic subdural hematoma (CSH) represents one of the most frequent types of intracranial hemorrhage. A standard surgical procedure is not available for each individual condition, and treatment options are often different at each institution. Therefore, management of CSH may represent a real challenge in the decision-making process of choosing a burr hole drainage instead of a large craniotomy in certain cases with borderline features. Prognosis depends directly on the appropriate selection of the surgical procedure. In this study we included 100 patients with CSH in order to analyze surgical results. The majority of the hematomas had a frontoparietal location in both cerebral hemispheres. The procedure of choice was usually a burr hole drainage in most cases. We found incomplete drainage in 18% of cases, each of which underwent a new surgical procedure and pneumoencephalus in 11% of cases. Mortality was 2%, which was less than reported in previous studies.