Recurrence of CSHD after Single Burr-Hole Evacuation and Closed Drainage System Versus Double Burr Hole Evacuation and Closed Drainage System

  • ZUBAIR MUSTAFA KHAN Department of Neurosurgery, Lahore General Hospital/Punjab Institute of Neurosciences, Lahore
  • MOIN ISLAM Department of Neurosurgery, Lahore General Hospital/Punjab Institute of Neurosciences, Lahore
  • TARIQ IMRAN KHOKHAR Department of Neurosurgery, Lahore General Hospital/Punjab Institute of Neurosciences, Lahore
  • HAFIZ ABDUL MAJID Department of Neurosurgery, Lahore General Hospital/Punjab Institute of Neurosciences, Lahore
Keywords: Chronic subdural hematoma, Burr-hole craniostomy

Abstract

Objective: The recurrence rate was compared after single burr hole evacuation and closed drainage system versus double burr hole evacuation and closed drainage system of CSHD.
Material and Methods: Sixty cases were included and randomized into two equal groups. Patient fulfilling the inclusion criteria were enrolled through the emergency and outdoor. CT scan brain was done and site, size and thickness of CSDH were evaluated. Patient were treated in exactly the same way as per standard ward routine practice except that the treatment option (whether to use the single or double burr hole) was decided through randomization by using random tables, Group A with single burr hole and Group B with double burr hole with closed drain used in both cases. Patients were kept admitted in the hospital till they were fit go home. Each patient was followed for recurrence at the 15th day, 1 month, 2 months and finally at 03 months.
Results: Total 60 patients of chronic subdural hematoma were included. Total cases were divided into two equal groups with 30 cases in group A (single burr hole) and 30 cases in group B (two burr holes). The mean age of all patients was 59 yrs with SD ± 12 with minimum age 40 yrs and maximum age 80 yrs. 
Conclusion: Most of the patients (82%) had recovered after burr-hole craniostomy. However, some patients (18%) suffer recurrence of hematoma. No significant difference in recurrence of CSDH with one burr hole or two burr holes and was found and also noticed that the rate of recurrence is to some extent lower with double burr hole than with one burr hole evacuation of chronic subdural hematoma.

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Published
2018-12-13
Section
Original Article