Outcome of Chronic Subdural Haematoma Patients Following Burr Hole Craniostomy and Irrigation without Post-Operative Drain

Abstract

Objective: To evaluate the efficacy of burr whole craniostomy and irrigation without any post-operative drainage in the treatment of patients of Chronic subdural hematoma (CSDH). Methods: This was a prospective study. A total of 50 patients of CSDH were included in the study. The clinical history of patients was noted. At the time of admission, level of consciousness as well as Galsgow Coma Score (GCS), conditions of the pupil as well as long tract signs in any of the limbs were recorded. All patients undergone for computed tomography (CT) at pre and 48 hours after operation. The findings of CT were recorded. Results: The mean age of patients was 61.00±12.33 ranging from 20-90 years. Majority were males (78%). Headache (92%) and hemi paresis (76%) were the most common clinical presentation. Previous history of trauma was present among half of patients (50%). Incontinence was present in 26% of patients. Right side subdural haematoma was involved in 48% of patients. Bilateral was in 32% patients. After 48 hours post-operative, CT showed that 52% patients of unilateral CSDH did not had Residual collection not causing midline shift. Of the bilateral CSDH, 60% patients had no collection. Clinically, there was improvement among 92% patients. Conclusion: Burr whole craniostomy with intraoperative irrigation and without post-operative drainage is an effective treatment option for CSDH. The results of surgical intervention with one burr hole are as good as using 2 burr holes for drainage of hemispheric chronic subdural haematoma.