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Treatment of Chronic Subdural Haematoma: Case for Single Burr-hole Craniostomy and Irrigation
Abstract
Introduction: Chronic subdural haematoma (CSH) is a common neurosurgical disease in the elderly which can pose diagnostic challenge. The best means of its surgical management remains controversial. Current treatment options include burr-hole
craniostomy, twist-drill craniostomy or craniotomy with or without closed tube drainage. While burr-hole craniostomy is often the most used technique, there are no articles that
provided class 1 evidence with respect to recurrence rates and complications. Objective: To review retrospectively the results obtained in our centre using the single burr craniostomy with irrigation. Patients and Methods: Two cases of CSH are reported and our local experience analysed. The data were obtained by the review of all the records of CSH cases treated at the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria between February 2006 and January 2008.
Results: There were 22 patients (19 males, 3 females). All were operated on. The median age was 65years. Two patients were alcoholics and CSH followed endoscopic third ventriculostomy in one case. The most common side affected was the left (Left side 10, Right side- 8, Bilateral 5). Post-operatively there were neither recurrences nor mortality. Conclusion: We conclude that for the treatment of the CSH, single burr-hole drainage with irrigation is associated with acceptable and satisfactory outcome. But a long term study will be appropriate to appropriately document the long term recurrence rate.
craniostomy, twist-drill craniostomy or craniotomy with or without closed tube drainage. While burr-hole craniostomy is often the most used technique, there are no articles that
provided class 1 evidence with respect to recurrence rates and complications. Objective: To review retrospectively the results obtained in our centre using the single burr craniostomy with irrigation. Patients and Methods: Two cases of CSH are reported and our local experience analysed. The data were obtained by the review of all the records of CSH cases treated at the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria between February 2006 and January 2008.
Results: There were 22 patients (19 males, 3 females). All were operated on. The median age was 65years. Two patients were alcoholics and CSH followed endoscopic third ventriculostomy in one case. The most common side affected was the left (Left side 10, Right side- 8, Bilateral 5). Post-operatively there were neither recurrences nor mortality. Conclusion: We conclude that for the treatment of the CSH, single burr-hole drainage with irrigation is associated with acceptable and satisfactory outcome. But a long term study will be appropriate to appropriately document the long term recurrence rate.
