Number of burr holes as independent predictor of postoperative recurrence in chronic subdural haematoma
- 1 January 2008
- journal article
- research article
- Published by Informa UK Limited in British Journal Of Neurosurgery
- Vol. 22 (2), 279-282
- https://doi.org/10.1080/02688690701818885
Abstract
Chronic subdural haematoma (cSDH) is one of the most frequent neurosurgical entities. Current treatment options include burr hole craniostomy, twist drill craniostomy or craniotomy. While burr hole craniostomy is the most often used technique, there are no studies analysing the use of one vs. two burr holes in respect to recurrence rates and complications. This retrospective study included 76 (age: 60 ± 12 years) patients presenting with cSDH admitted in our institution from January 2004 to December 2005. A total of 21 (27%) patients underwent bilateral craniostomy. The patients were assessed using the Markwalder Scale (2 ± 0.71), Glasgow Coma Scale (14 ± 1) and measuring the haematoma thickness (1.8 ± 0.7 cm). The decision to perform one or two burr hole was made according to the personal preference of the treating neurosurgeon. All patients underwent irrigation and placement of closed-system drainage. Out of the 97 haematoma, 63 (65%) haematomas were treated with two burr holes, whereas 34 (35%) were treated with one burr hole. Patients with one burr hole had a statistically significant (p < 0.05) higher recurrence rate (29 vs. 5%), longer average hospitalization length (11 vs. 9 days) and higher wound infection rate (9% vs. 0%). A multivariate regression analysis identified the number of holes as single predictor for postoperative recurrence rate (r2 = 0.12; p < 0.001). In this study, the treatment of cSDH with one burr hole only is associated with a significantly higher postoperative recurrence rate, longer hospitalization length and higher wound infection rate.Keywords
This publication has 26 references indexed in Scilit:
- Bedside twist drill craniostomy for chronic subdural hematoma: a comparative studySurgical Neurology, 2006
- Treatment of chronic subdural hematoma by burr-hole craniostomy in adults: influence of some factors on postoperative recurrenceActa Neurochirurgica, 2005
- Outcome of contemporary surgery for chronic subdural haematoma: evidence based reviewJournal of Neurology, Neurosurgery & Psychiatry, 2003
- Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrenceJournal of Neurosurgery, 2001
- Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainageJournal of Neurosurgery, 2000
- Kallikrein-kinin system in chronic subdural haematomas: its roles in vascular permeability and regulation of fibrinolysis and coagulation.Journal of Neurology, Neurosurgery & Psychiatry, 1995
- Chronic Subdural HematomaNeurosurgery, 1993
- Chronic subdural haematoma treated by burr holes and closed system drainage: Personal experience in 131 patientsBritish Journal Of Neurosurgery, 1991
- Efficacy of Closed-System Drainage in Treating Chronic Subdural Hematoma: A Prospective Comparative StudyNeurosurgery, 1990
- The course of chronic subdural hematomas after burr-hole craniostomy and closed-system drainageJournal of Neurosurgery, 1981