Treatment of chronic subdural hematoma through a burr hole

Chronic subdural hematoma (CSH) is usually a cranial encephalic trauma present in 1/100,000 cases in subjects >70 years old. We undertook this study to report the experience obtained in the treatment of CSH using the technique of evacuation of the hematoma through a burr hole, irrigation and closed system drainage under local anesthesia.

We performed a retrospective and descriptive study from 1999 to 2008. Files of clinical and radiological diagnoses of adult patients with CSH were reviewed and corroborated with computed axial tomography (CAT) and who were subjected to drainage of the CSH.

Seventeen patients were surgically intervened (average age: 72 years). All patients were male and there was a history of trauma in all. Three of the 17 patients had been subjected to an aggression. The average time between injury and symptom onset was 6 weeks. According to the scale of Markwalder, 65% were classified as grade I, 29% as grade II and 6% as grade III. According to CAT, most of the bruises were hypodense and unilateral. As to the effect of the mass according to the scale of Gordon-Firing, 82% were classified as grades II and III.

Treatment of CSH through a burr hole, irrigation and closed system drainage under local anesthesia is simple, safe and effective.