Abstract
Objectives: Chronic subdural hematoma (CSDH) is one of the most common entities treated in neurosurgery. Postoperative subdural drainage employed after burr hole evacuation for treating CSDH reduces recurrence, but whether it leads to increased surgical complications compared to no postoperative drainage is debatable. The present study was designed to assess whether postoperative subdural drainage leads to increased surgical complications following burr hole evacuation of CSDH compared to no drainage.
 Materials and Methods: The medical records of 69 patients treated with burr hole evacuation for chronic subdural hematoma between July 2013 to April 2014 were retrospectively analyzed. The patients were divided into two groups. In group A patients, postoperative subdural drainage had been employed following burr hole evacuation of CSDH, while in group B patients there was no drainage. The two groups were then compared for the development of surgical complications other than recurrence.
 Results: Sixteen patients developed complications. Acute Subdural hematoma formed in 3 patients. There was intraparenchymal drain insertion in 6 patients. An empyema developed in 2 patients, while one patient each developed an Extradural hematoma, fits, contusion, and hemorrhagic infarction. All the complications occurred in the group A patients receiving postoperative subdural drainage. Postoperative subdural drainage tube was found to be significantly associated (p = 0.0017) with complications.
 Conclusion: We conclude that postoperative subdural drainage following burr hole evacuation of chronic subdural hematoma is associated with increased surgical complications compared to no drainage.
Highlights
Chronic subdural hematoma (CSDH) is one of the most commonly encountered pathologies in neurosurgery.[1,2,3,4,5,6] The incidence of chronic subdural hematoma has been reported in the literature to be as high as 13.1 cases per 100000 population.[6]
We conclude that postoperative subdural drainage following burr hole evacuation of chronic subdural hematoma is associated with increased surgical complications compared to no drainage
Multiple studies comparing postoperative subdural drainage with no drainage found that the recurrence is reduced in the group of patients receiving subdural drainage, and the surgical complications do not get increased in that group.[13,14,15,16]
Summary
Chronic subdural hematoma (CSDH) is one of the most commonly encountered pathologies in neurosurgery.[1,2,3,4,5,6] The incidence of chronic subdural hematoma has been reported in the literature to be as high as 13.1 cases per 100000 population.[6]. Recent studies have consistently shown contrasting results for these two sets of studies regarding the association of subdural drainage with complications with one set of studies showing increased complications associated with subdural drainage and the other showing no difference in complications when subdural drainage is instituted.[13,14,15,16,17,18,19,20] The association of postoperative subdural drainage with increased complications becomes controversial.
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