BURR-HOLE DRAINAGE WITH DRAIN VERSUS BURR-HOLE DRAINAGE WITH DRAIN AND IRRIGATION IN TREATING CHRONIC SUBDURAL HEMATOMA: A CASE-CONTROL STUDY

Ari Anwer Salih a and Ari Sami Hussain Nadhim b



Neurosurgery Trainee, Shar Teaching Hospital, Sulaymaniyah, KRG, Iraq.
b Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 

 

Submitted: 1/1/2019; Accepted: 1/2/2020; Published: 21/9/2020

ABSTRACT


Background 

Chronic subdural hematoma is a common neurosurgical condition. Its prevalence is increasing worldwide due to the increasingly aged population. Craniotomy, twist-drill craniostomy, and burr-hole drainage and drain with or without irrigation are among the very first lines of its management.


Objectives 

We used burr-hole drainage with drain versus burr-hole drainage with drain and irrigation to find out which method is better regarding the outcome of chronic subdural hematoma treatment.


Patients and Methods

a case-control study design was used to inspect retrospectively both techniques in 47 patients. Twenty-one patients were treated with burr-hole drainage with drain only, and 26 were treated with burr-hole drainage with drain and irrigation.


Results

We found no statistically different association between the two types of operations and their outcomes (P value= 0.083 and Pearson’s R Correlation= 0.029).


Conclusion

As long as there is no differences between the two techniques, irrigation is not necessary after burr-hole drainage of chronic subdural hematoma. It requires more time, more exposure of the patient to anesthetic agents, and increases the risk of both infection and pneumocephalus.



KEYWORDS

Chronic subdural hematoma (CSDH); Burr-hole drainage; Irrigation; Outcome.