SPECIAL ISSUE PAPER
Comparing Clinical Responses to Using One Burr Hole and Two Burr Holes to Treat Chronic Subdural Hematoma
 
More details
Hide details
1
Department of Neurosurgery, Arak University of Medical Sciences, Arak, IRAN
2
Department of Anesthesiology, Arak University of Medical Sciences, Arak, IRAN
Online publish date: 2018-02-03
Publish date: 2018-02-03
 
Eurasian J Anal Chem 2018;13(3):em19
KEYWORDS:
ABSTRACT:
The therapeutic strategies currently used to treat chronic subdural hematoma (CSDH) include various methods such as craniotomy and twist drill or utilizing Burr hole. The present research seeks to make a clinical comparison between using one burr hole and two burr holes to treat CSDH. This is a randomized, double-blind clinical trial conducted on 70 patients suffering from CSDH candidated for using burr hole. The participants were divided into two equal groups and underwent treatment with 1 burr hole or 2 burr holes. The primary and secondary outcome variables were compared across the two groups prior to and 48 hours following the operation. A total number of 5 death cases were (7.14%) were reported among patients. 2 patients (5.71%) were in the 1 burr hole group, while 3 (8.57%) were in the 2 burr hole group (P = 0.514). The need for undergoing a secondary operation in the 2 burr holes group (1 case, i.e. 2.85%) was significantly less than what was reported in the other group (6 cases, i.e. 17.14%) (P = 0.012). The mean time of hospitalization (1 burr hole: 4.98, 2 burr holes: 3.1, P = 0.001), the pneumosephalus levels 48 hours following the operation (1 burr hole: 9.38, 2 burr holes: 5.91, P = 0.012) and hematoma levels 48 hours following the operation (1 burr hole: 41.57, 2 burr holes: 30.85, P = 0.0001) in the 2 burr holes group were significantly less than what were reported in the other group. 48 hours after the operation, the hematoma volume (1 burr hole: P= 0.031, 2 burr holes: P= 0.002) in both groups exhibited a significant reduction compared to what was observed before the operation. Using 1 or 2 burr holes are quite useful methods to treat CSDH patients. However, the clinical outcome of those patients in the 2 burr holes group was much more favorable.
 
REFERENCES (15):
1. Regan JM, Worley E, Shelburne C, Pullarkat R, Watson JC. Burr hole washout versus craniotomy for chronic subdural hematoma: patient outcome and cost analysis. PLoS One. 2015;10(1):e0115085. https://doi.org/10.1371/journa....
2. Chen JC, Levy ML. Causes, epidemiology, and risk factors of chronic subdural hematoma. Neurosurg Clin N Am. 2000;11(3):399-406.
3. Ledić D, Girotto D, Pal S, Kolbah B. Risk factors for subdural bleeding in elderly population. Coll Antropol. 2014;38(4):1195-8.
4. Massobrio L, Rosa GM, Montecucco F, Valbus A. Treatment with apixaban in a patient with recent chronic subdural haematoma: a case report. Swiss Med Wkly. 2015;145:w14048. https://doi.org/10.4414/smw.20....
5. Baechli H, Nordmann A, Bucher HC, Gratzl O. Demographics and prevalent risk factors of chronic subdural haematoma: results of a large single-center cohort study. Neurosurg Rev. 2004;27(4):263-6. https://doi.org/10.1007/s10143....
6. Lee JY, Ebel H, Ernestus RI, Klug N. Various surgical treatments of chronic subdural hematoma and outcome in 172 patients: is membranectomy necessary. Surg Neurol. 2004;61(6):523- 7. https://doi.org/10.1016/j.surn....
7. Allahdini F, Afkhamzadeh A, Amirjamshidi A, Delpisheh A. Factors Affecting the Outcomes of Patient's Suffering from Chronic Subdural Hematoma after Surgery by Burr-hole Hole-Drainage Method; a Cross Sectional Survey. Iranian surgery journal. 2010;18(3):40-51.
8. Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry. 2003;74(7):937-43. https://doi.org/10.1136/jnnp.7....
9. Lega BC, Danish SF, Malhotra NR, Sonnad SS, Stein SC. Choosing the best operation for chronic subdural hematoma: a decision analysis. J Neurosurg. 2010;113(3):615-21. https://doi.org/10.3171/2009.9....
10. Taussky P, Fandino J, Landolt H. Number of burr holes as independent predictor of postoperative recurrence in chronic subdural haematoma. Br J Neurosurg. 2008;22(2):279-282. https://doi.org/10.1080/026886....
11. Kawamata T, Takeshita M, Kubo O, Izawa M, Kagawa M, Takakura K. Management of intracranial hemorrhage associated with anticoagulant therapy. Surg Neurol. 1995;44(5):438-43. https://doi.org/10.1016/0090-3....
12. Robinson RG. Chronic subdural hematoma: surgical management in 133 patients. J Neurosurg. 1984;61(2):263-8. https://doi.org/10.3171/jns.19....
13. Drapkin AJ. Chronic subdural hematoma: pathophysiological basis for treatment. Br J Neurosurg. 1991;5(5):467-73. https://doi.org/10.3109/026886....
14. Tokmak M, Aras AB, Baltepe Altıok I, Guven M, Coşar M. Chronic Spinal Epidural Hematoma in an Adult. European Journal of General Medicine. 2015;12(3):267-70. https://doi.org/10.15197/ejgm.....
15. Htwe O, Naicker AS, Pei TS. Spinal epidural hematoma due to anticoagulant therapy: a case report and literature review. European Journal of General Medicine. 2016;13(3):61–2. https://doi.org/10.29333/ejgm/....
eISSN:1306-3057