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Outcome of Chronic Subdural Hematoma Treated with Single Burr Hole Under Local Anesthesia
Abebe Mersha1, Sahlu Abat1, Tsegaye Temesgen1
1Addis Abeba University, Collage of health science, School of medicine, Department of surgery.
Insights
Single burr hole craniostomy effectively treats chronic subdural hematoma (CSDH) in elderly patients, offering a safe and simple surgical option for primary hospitals. This procedure resulted in good recovery for most patients.
Area of Science:
- Neurosurgery
- Geriatric Medicine
- Surgical Procedures
Background:
- Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition, predominantly affecting the elderly.
- Existing surgical interventions for CSDH vary, necessitating evaluation of simpler, effective methods.
Purpose of the Study:
- To assess the postoperative outcomes of patients surgically treated for CSDH.
- To identify an easy, safe, and effective surgical procedure for CSDH suitable for primary hospitals.
Main Methods:
- A retrospective cross-sectional study analyzed 195 patients operated for CSDH between 2012 and 2015.
- Descriptive statistics were employed to evaluate postoperative outcomes, including hospital stay, complications, and recurrence rates.
Main Results:
- The study included a male predominance (70.3%) with a mean age of 57.63 years; 68.2% were over 55.
- Single burr hole craniostomy with closed system drainage under local anesthesia was performed on all patients.
- A 95.9% good recovery rate was observed, with a mean hospital stay of 3.68 days; recurrence occurred in 6.6%.
Conclusions:
- Single burr hole craniostomy is a straightforward, safe, and highly effective treatment for CSDH.
- This technique is well-suited for implementation in primary-level hospitals, improving patient outcomes.
Background:
Chronic subdural hematoma (CSDH) is a common condition encountered in daily neurosurgical practice usually affecting the elderly population. Various surgical procedures have been used for the evacuation of hematoma in patients with CSDH. The objective of this paper was to study the postoperative outcome of patients who were operated for CSDH and to describe the easy, safest and effective procedure that can be performed at primary level hospitals.
Methods:
Institutional based cross-sectional retrospective study was conducted among patients operated for CSDH from January 1, 2012 to December 31, 2015 at Teklehaymanot General Hospital, a private hospital in Addis Ababa, Ethiopia. Descriptive statistics, using SPSS version 20, was used to determine the postoperative outcomes including hospital stay, complications and recurrence rate.
Results:
Of the 195 charts reviewed, 70.3% were of males, with M: F ratio of 2.4:1. 68.2% of patients being above the age of 55 years with a mean age at presentation of 57.63. The most common presenting symptom was headache followed by extremity weakness. The diagnosis of CSDH was made with either head CT scan or MRI. Forty one percent of patients had a left side hematoma and 48(24.6%) patients had bilateral CSDH. All patients were operated with a single burr hole evacuation under local anesthesia and postoperative subdural closed system drainage by a single neurosurgeon. The mean hospital stay was 3.68±2.6 days. The postoperative outcome was assessed using the Glasgow Outcome Score, and 95.9% of the patients reported good recovery. Thirteen (6.6%) patients were operated twice for recurrence, and there were four deaths.
Conclusions:
Single burr hole craniostomy is an easy, safe and effective technique for the treatment of CSDH.
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