Clinical efficacy of chronic subdural hematoma using two modified surgical procedures

Abstract

Objective To introduce two modified surgical procedures for the treatment of chronic subdural hematoma (CSDH) and explore their clinical efficacies. Methods The clinical data of 100 CSDH patients, admitted to our hospital from March 2012 to February 2017, were retrospectively analyzed. Hematoma evacuation plus T-tube drainage was performed in 43 patients and minimally invasive microsurgery in 57 patients. Follow up of treatment efficacies was performed. Results During surgery, hematoma drainage of 5 patients (5%) was poor and the removal of hematoma was expanded. The clinical symptoms and signs of all of the patients improved after operation. Postoperative 24 h CT indicated that the ipsilateral subdural subdural effusion was found in 36 patients (36%), a small amount of ipsilateral subdural air was found in 13 patients (13%), and a small amount of residual hematoma was found in 6 patients (6%). Follow up for 3-6 months indicated that subdural subdural effusion, subdural air and residual hematoma were absorbed completely; no hematoma recurrence, intracranial infection, scalp incision infection or death were noted; contralateral chronic subdural hematoma was found in one patient (1%), and hematoma was absorbed after conservative treatment. Clinical symptoms and signs of all patients were significantly improved and disappeared. Conclusion The minimally invasive double-hole hemodilution assisted with T-tube wall-draining or minimally invasive hematoma evacuation can effectively treat CSDH, and the postoperative complications are few; the above two surgical methods are worthy of clinical use, especially application and popularization of primary hospital. Key words: Chronic subdural hematoma; Drilling drainage; Small bone flap; Complication