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The impact of membranectomy on chronic subdural hematoma outcomes: a meta-analysis and systematic review

Donald E Ogolo1, Okwunodulu Okwuoma2, Kelechi Ndukuba3

  • 1Division of Neurosurgery, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria - donald.ogolo@npmcn.edu.ng.

Journal of Neurosurgical Sciences
|February 13, 2026
PubMed
Abstract

Insights

Membranectomy significantly lowers chronic subdural hematoma recurrence but increases seizure risk. Burr-hole drainage is preferred for simple cases, while craniotomy with membranectomy suits complex or recurrent hematomas.

Area of Science:

  • Neurosurgery
  • Clinical Outcomes Research

Background:

  • Chronic subdural hematoma (CSDH) is a prevalent neurosurgical issue.
  • The efficacy of membranectomy in preventing CSDH recurrence is debated.

Purpose of the Study:

  • To evaluate if membranectomy improves outcomes compared to non-membranectomy surgical techniques for CSDH.
  • To analyze recurrence rates, functional recovery, and complications associated with membranectomy.

Main Methods:

  • Systematic literature search of PubMed, Embase, and Cochrane databases.
  • Inclusion of 15 studies with 1,593 patients comparing membranectomy versus non-membranectomy approaches.
  • Meta-analysis using random-effects models to pool outcomes.

Main Results:

  • Membranectomy demonstrated a 54.2% reduction in CSDH recurrence (OR: 0.45).
  • Improved functional recovery (GOS 4-5) was observed with membranectomy (OR: 1.42).
  • An increased risk of seizures was associated with membranectomy (OR: 1.89).

Conclusions:

  • Membranectomy effectively reduces CSDH recurrence but elevates seizure risk.
  • Burr-hole drainage is recommended for uncomplicated CSDH.
  • Craniotomy with membranectomy may be beneficial for organized or recurrent CSDH.

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