ABSTRACT
BACKGROUND AND OBJECTIVES: In most neurosurgical centers, irrigation is an essential part of the surgical procedure for chronic subdural hematoma (CSDH). However, it is unknown whether the volume of irrigation fluid affects the risk of CSDH recurrence. This study aimed to investigate a potential association between the volume of irrigation fluid used during burr hole evacuation of CSDH and the risk of CSDH recurrence. METHODS: This study is a subanalysis of 2 randomized trials (Drain Time & Drain Time 2) designed to investigate the effect of drainage duration on the recurrence of CSDH. Intraoperative irrigation volume was measured, and patients were followed for 90 days for recurrent CSDH. RESULTS: A total of 525 patients with CSDH were included. There was no significant difference in the volume of irrigation fluid used between patients with recurrence (mean = 938 mL, SD = ±552) and without recurrence (mean = 852 mL, SD = ±454) ( P -value = .15). Patients with recurrent CSDH had larger primary CSDH volumes (mean = 134 cm 3 , SD = ±69) than patients without recurrence (mean = 119 cm 3 , SD = ±58) ( P = .04). Multiple logistic regression analysis revealed no association between irrigation volume and recurrence, also when stratified for hematoma size. CONCLUSION: There was no significant association between irrigation volume and recurrent CSDH within 90 days in patients undergoing burr hole surgery for CSDH.
Subject(s)
Hematoma, Subdural, Chronic , Humans , Hematoma, Subdural, Chronic/surgery , Trephining/methods , Craniotomy/methods , Drainage/methodsABSTRACT
Chronic subdural haematoma (CSDH) is a collection of liquefied blood between the dura mater and the arachnoid layer of the brain. The incidence of CSDH increases with age and with an ageing population, and a rise in CSDH prevalence is anticipated. The Danish Chronic Subdural Hematoma Study was created on behest of the four neurosurgical departments in order to standardise treatment, research and development as well as creating the first Danish national guidelines in CSDH management. These guidelines are presented in this review.
