The rate of re-operation in patients with chronic subdural hematoma
Chronic subdural hematoma is a collection of liquefied blood between the dura and arachnoid layer of the brain which thought to result from injury to bridging veins crossing the subdural space. Patients with chronic subdural haematomas can present in a variety of ways, and symptom onset and progression may range from days to weeks. Surgical approach with standard methods is still controversial.
Objective: to compare patients outcome following two surgical approaches with or without closed system drainge.
Patients and methods: The present prospective cohort study included 40 patients with subdural hematoma throughout the period extending from January 2010 to August 2014. Two bur hole craniostomies (12 mm in diameter) were made in each patients; one in front of the coronal suture and the other behind the hematoma and the procedure was done without membranectomy. In 15 cases, closed system drainage was placed into the hematoma cavity for an average of 2 days (1 to 3 days) after irrigation with physiologic saline solution.
Results: The outcome after operation was as following: 5 out of 25 patients in the first group needed re-operation accounting for a rate of (20%). The rate was slightly lower in the second group; 2 out of 15 (13.3%). The difference in rate of re-operation was not significant (P> 0.05)
Conclusion: The use of subdural closed drainage system is not superior to drainage and simple closure in treatment of chronic subdural hematoma.