Outcomes of Two Burr Holes with Subpericranium Closed-system Drainage of Non-acute Subdural Hematoma

Abstract

Outcomes of Two Burr Holes with Subpericranium Closed-system Drainage of Non-acute Subdural Hematoma

Chaiwan            Charoenchoketavee       MD

Department of Surgery, BMA Medical College and Vajira Hospital

Objective : To study the surgical outcomes of 2 burr holes with subpericranium close-system drainage of non-acute subdural hematoma and the related factors.

Study design : Descriptive study.

Subjects : Eighty two patients with non-acute subdural hematoma whom were treated by this surgical technique at BMA Medical College and Vajira Hospital between January 1, 1996 and December 31, 2000.

Methods The clinical findings in the medical records and surgical outcomes were reviewed, the CT scan films of all patients were evaluated and divided into 2 groups: iso-density hematoma images and low-density hematoma images. The analysis was performed by differentiating low-density hematoma images and iso-density hematoma images and the over all outcomes. All survivors were followed up at least 3 months after surgery.

Main outcome measures Surgical outcomes and related factors determined statistical significantly.

Results Two burr holes with subpericranium closed-system drainage of non-acute subdural hematoma had recurrence rate 4.9%, mortality rate 4.9%. Post-operative outcomes were 90.2% improvement. The surgical outcomes influence factors were ages, hematoma density, history of previous trauma, concomittant diseases, pre-operative grading. Post-operative drainage volume and re-operation were not involved the surgical outcomes. The iso-density group had lower ages, more history of trauma, better outcomes than low-density group. There was no different of post-operative drainage volume in both groups. The factors that prolonged hospitalization more than 10 days were age, history of trauma and re-operation.

Conclusion : This surgical operative procedure had a good outcomes, low recurrence rate and excellent post-operative outcomes. The surgical outcomes influenced factors in both groups were age, history of trauma and re-operation. Iso-density group had more better surgical outcomes.

Key words : non-acute subdural hematoma, close-system drainage, 2 burr holes technique

Vajira Med J 2001 ; 45 : 93 - 105