Outcome of Aspiration and Drain Placement in Chronic Subdural Hematoma

Mumtaz Ali, Lal Rehman, Raza Rizvi

Abstract

Objective

To find the results of chronic subdural hematoma (CSDH) treatment by aspiration and drain placement after burr-hole.

Study design

Descriptive study.

Place & Duration of study

Department of Neurosurgery, Jinnah Postgraduate Medical Centre Karachi, from August 2017 to December 2019.

Methodology

Patients of all age groups and both genders were included. CT scan brain was used to confirm the diagnosis of CSDH at least three weeks after the insult. Patients with recurrent CSDH were excluded. All the patients underwent burr-hole with aspiration of hematoma and subdural drain placement. Postoperative complications were noted. All patients were followed in outpatients department and CT Scan brain was repeated. All of them were observed for clinical improvement or otherwise.

Results

A total of 159 patients were included in the study. There were 132(83%) male and 27 (17%) female patients. CSDH was found on right side in 70 (44%) patients, left side in 65 (40.9%) patients and bilateral in 24 (15.1%)patients. In 130 (81.8%)patients there was a history of trauma, 24 (15.1%) were using medication while 5 (3.1%) patients had bleeding disorder. Preoperative GCS score was 9.62+2.45 and postoperative GCS score 13.17+1.83. Postoperative complication rate was 15.09%. Four (2.5%) patients had CSF leak, 3 (1.9%) developed pneumocephalus, and wound infection occurred in 3 (1.9%) patients. Fourteen (8.8%) patients developed recurrent CSDH.

Conclusion

Chronic subdural hematoma treatment with burr-hole aspiration and drain placement was found successful with minimum morbidity and mortality.

Key words

Chronic subdural hematoma, Burr-hole, Aspiration, Drain placement.