Chronic Subdural Hematoma: Surgical Management and Outcome in Newly Established Neurosurgical Unit: Experience of 78 Patients Operated over 1 Year

Abstract

Objective: Chronic subdural hematoma (CSDH) has an increasing incidence and results in high morbidity and mortality. With the increasing age, the number of the elderly patient is coming frequently with symptoms of headache and hemiparesis. We review here the 1-year experience of a single institution and the literature regarding the treatment and major associations of CSDH and some patients with subacute subdural hematomas. Materials and Methods: Analysis of 78 cases of Chronic SDH operated in department of Neurosurgery for a period of one year. Burr-hole evacuation with and without closed system drainage has been the operative technique of the first choice at our institution for 4 consecutive years. Results: Our results indicated that neurological status on admission was the best predictor of outcome. The use of the drain had a significant reduction in the recurrence rates. With regard to the other data, age, brain atrophy, thickness and density of hematoma, subdural accumulation of air, and antiplatelet and anticoagulant therapies were found to correlate significantly with prognosis. Conclusions: Burr-hole evacuation is a relatively safe and effective first-line management option. All cases were operated under local anaesthesia. The patients had excellent recovery postoperatively. The recurrence rate is not associated with the use of a drain after burr-hole evacuation of a CSDH, proper irrigation, and closure reduce complications.