Chronic Subdural Hematoma Treated By Two Burr-Hole Craniostomy And Closed-System Drainage In Elderly Patients
Keywords:chronic subdural hematoma, burr-hole, drainage, outcome and recurrence
Objective: This retrospective study of the records of 45 patients over than 60s years with chronic subdural hematoma treated with two burr-holes craniostomy with closed-system drainage was carried out.
Methods: Between 1995 and 2007 at Gulhane Military Medical Academy, Neurosurgery Department, 45 consecutive patients over than 60s years treated with two burr-holes craniostomy with closed-system drainage for chronic subdural hematoma were evaluated for etiology, preoperative and postoperative early follow-up symptoms and signs, Karnofsky performance score, computerized tomography (CT) scan results, and complications.
Results: The series included 32 males and 13 females, mean age 76,3 years. The principal symptom was altered mental status, gait disturbance, and headache. 11 patients had no etiological factors. Karnofsky performance score was 64,89 preoperatively, and 70,67 postoperatively. The mean thickness of the hematoma was 2,14 cm preoperatively, and 0,9 cm postoperatively. No complications occurred due to surgery. 6 patients died in hospital due to systemic complications. We performed the second operation in 8 cases.
Conclusion: Burr-hole with a closed drainage system is a simple, safe and efficient method for the treatment of CSDHs with a low rate of complications. In our experience, the worst prognostic factors for the outcome of CSDH patients were the neurological conditions and additional systemic diseases at the time of surgery.