Effectiveness of Burr Hole Sizes on Midline Shift and Hematoma Thickness in the Treatment of Chronic Subdural Hematoma

Abstract

The aim of this study was to investigate the effect of burr hole width on postoperative chronic subdural hematoma thickness and midline shift radiologically. The files of 92 patients who were operated after diagnosis of Chronic Subdural Hematoma between April 1, 2015 and July 1, 2021 were reviewed retrospectively. Preoperative and postoperative computerized tomography (CT) scans were scrutinized and the thickness of hematoma and midline shift and the diameters of two burr holes opened were measured and recorded. The correlation between burr hole diameter width and chronic subdural hematoma thickness in postoperative CT and improvement in midline shift was investigated statistically. When the CT scans performed on the postoperative 1st day and postoperative 1st month were examined, it was determined that the preoperative hematoma thickness and midline shift were significantly reduced (p<0.001). A positive significant correlation was found between the improvement of the midline shift, the posterior burr hole diameter and the anterior-posterior burr hole arithmetic mean (p<0.001; p=0.029, respectively). Having examined the current surgical treatment techniques in the treatment of chronic subdural hematoma, we found that an increase in the width of burr hole craniotomies (BHC), especially the posterior BHC, contributed to the improvement in midline shift.