Reduction in the number of repeated operations for the treatment of subacute and chronic subdural hematomas by placement of subdural drains

Christopher R. P. LindDepartment of Neurosurgery, Auckland Hospital, Auckland, New Zealand

Search for other papers by Christopher R. P. Lind in
Current site
Google Scholar
PubMed
Close
 M.B., Ch.B.
,
Christina J. LindDepartment of Neurosurgery, Auckland Hospital, Auckland, New Zealand

Search for other papers by Christina J. Lind in
Current site
Google Scholar
PubMed
Close
 M.B., Ch.B., M.Sc.
, and
Edward W. MeeDepartment of Neurosurgery, Auckland Hospital, Auckland, New Zealand

Search for other papers by Edward W. Mee in
Current site
Google Scholar
PubMed
Close
 F.R.C.S.
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $525.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $624.00
USD  $45.00
USD  $525.00
USD  $624.00
Print or Print + Online Sign in

Object. The aim of this study was to determine the influence of closed-system subdural drainage on repeated operation rates after burr hole evacuation of subacute and chronic subdural hematomas (SDHs).

Methods. Five hundred consecutive operations for the treatment of SDH via burr holes were performed between January 1, 1996, and April 15, 2002, at the Auckland Hospital. Hospital records were used to ascertain demographic data, operation, and repeated operation details. Rates of repeated surgeries were compared in patients with and without subdural drains.

Repeated operations were performed less frequently in patients with subdural drains, occurring in 31 (10%) of 310 cases involving drains and in 35 (19%) of 188 cases without drains (p < 0.01). Demographics between the two groups were not significantly different except for mean patient age, which was higher among patients with a subdural drain. A lower rate of repeated operation was observed in patients who had undergone drain placement, regardless of whether there was visible evidence of brain reexpansion.

Conclusions. Patients have lower rates of repeated surgeries if subdural drains are placed following evacuation of an SDH via a burr hole. To reach high clinical significance, 12 patients must undergo this simple intervention. If technically feasible, subdural drains should be inserted regardless of any occurrence of brain expansion during surgery.

  • Collapse
  • Expand
  • 1.

    Kotwica Z, & Brzezinski J: Chronic subdural haematoma treated by burr holes and closed system drainage: personal experience in 131 patients. Br J Neurosurg 5:461465, 1991 Kotwica Z, Brzezinski J: Chronic subdural haematoma treated by burr holes and closed system drainage: personal experience in 131 patients. Br J Neurosurg 5:461–465, 1991

    • Search Google Scholar
    • Export Citation
  • 2.

    Krupp WF, & Jans PJ: Treatment of chronic subdural haematoma with burr-hole craniostomy and closed drainage. Br J Neurosurg 9:619627, 1995 Krupp WF, Jans PJ: Treatment of chronic subdural haematoma with burr-hole craniostomy and closed drainage. Br J Neurosurg 9:619–627, 1995

    • Search Google Scholar
    • Export Citation
  • 3.

    Laumer R, , Schramm J, & Leykauf K: Implantation of a reservoir for recurrent subdural hematoma drainage. Neurosurgery 25:991996, 1989 Laumer R, Schramm J, Leykauf K: Implantation of a reservoir for recurrent subdural hematoma drainage. Neurosurgery 25:991–996, 1989

    • Search Google Scholar
    • Export Citation
  • 4.

    Markwalder TM, & Seiler RW: Chronic subdural hematomas: to drain or not to drain? Neurosurgery 16:185188, 1985 Markwalder TM, Seiler RW: Chronic subdural hematomas: to drain or not to drain? Neurosurgery 16:185–188, 1985

    • Search Google Scholar
    • Export Citation
  • 5.

    Mori K, & Maeda M: Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir 41:371381, 2001 Mori K, Maeda M: Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir 41:371–381, 2001

    • Search Google Scholar
    • Export Citation
  • 6.

    Nakaguchi H, , Tanishima T, & Yoshimasu N: Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage. J Neurosurg 93:791795, 2000 Nakaguchi H, Tanishima T, Yoshimasu N: Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage. J Neurosurg 93:791–795, 2000

    • Search Google Scholar
    • Export Citation
  • 7.

    Ohaegbulam SC: Surgically treated traumatic subacute and chronic subdural haematomas: a review of 132 cases. Injury 13:2326, 1981 Ohaegbulam SC: Surgically treated traumatic subacute and chronic subdural haematomas: a review of 132 cases. Injury 13:23–26, 1981

    • Search Google Scholar
    • Export Citation
  • 8.

    Robinson RG: Chronic subdural hematoma: surgical management in 133 patients. J Neurosurg 61:263268, 1984 Robinson RG: Chronic subdural hematoma: surgical management in 133 patients. J Neurosurg 61:263–268, 1984

    • Search Google Scholar
    • Export Citation
  • 9.

    Tabaddor K, & Shulman K: Definitive treatment of chronic subdural hematoma by twist-drill craniostomy and closed-system drainage. J Neurosurg 46:220226, 1977 Tabaddor K, Shulman K: Definitive treatment of chronic subdural hematoma by twist-drill craniostomy and closed-system drainage. J Neurosurg 46:220–226, 1977

    • Search Google Scholar
    • Export Citation
  • 10.

    Tsutsumi K, , Maeda K, & Iijima A, et al: The relationship of preoperative magnetic resonance imaging findings and closed system drainage in the recurrence of chronic subdural hematoma. J Neurosurg 87:870875, 1997 Tsutsumi K, Maeda K, Iijima A, et al: The relationship of preoperative magnetic resonance imaging findings and closed system drainage in the recurrence of chronic subdural hematoma. J Neurosurg 87:870–875, 1997

    • Search Google Scholar
    • Export Citation
  • 11.

    Wakai S, , Hashimoto K, & Watanabe N, et al: Efficacy of closed-system drainage in treating chronic subdural hematoma: a prospective comparative study. Neurosurgery 26:771773, 1990 Wakai S, Hashimoto K, Watanabe N, et al: Efficacy of closed-system drainage in treating chronic subdural hematoma: a prospective comparative study. Neurosurgery 26:771–773, 1990

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 832 187 71
Full Text Views 213 24 0
PDF Downloads 171 21 0
EPUB Downloads 0 0 0