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Category: Volume 10 Issue 11 November 2022
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Title: Burr Holes and Drainage for Chronic Subdural Heamatoma: Initial experience in 3 years in Bauchi, Nigeria

Authors: Olabisi Oluwagbemiga Ogunleye, Jeneral Dumura Alfin, Abdulkadir Adamu Jauro, Oluchukwu Blessing Ogunleye

 DOI: https://dx.doi.org/10.18535/jmscr/v10i11.14

Abstract

Introduction: Chronic subdural heamatoma is one of the commonest neurosurgical pathologies that require surgical intervention. Burr hole and drainage is the most frequent used surgical treatment.

Methods: A retrospective study of the clinical records of 93 patients managed surgically for chronic subdural hematoma using a burr hole and closed drainage system which spanned over three (3) years was conducted. Pre-operative clinical grading compared with clinical grading /outcome at discharge.

Results: Ninety percent of the patients had head trauma as the aetiology while hemiparesis/hemiplegia, headache and memory impairment are the three commonest modes of presentations in our study. More than 90% of the patients had good outcome.

Conclusion: Burr holes and closed drainage of chronic subdural heamatoma is simple, safe and effective treatment modality among our patients.

Keywords: burr-hole, drainage, subdural heamatoma.

References

  1. Agrawal A. Bilateral biconvex frontal chronic subdural hematoma mimicking extradural hematoma. Journal of surgical technique and case report. 2010; 2(2).
  2. Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurology Neurosurg Psychiatry. (2003) 74:937–43. doi: 10.1136/jnnp.74.7.937
  3. Maurice-Williams RS: Chronic subdural hematoma: An everyday problem for the neurosurgeon. Br J Neurosurg 1999;13:547–549.
  4. Sahyouni R, Goshtasbi K, Mahmoodi A, Tran DK, Chen JW. Chronic subdural hematoma: A historical and clinical perspective. World Neurosurg. 2017; 108: 948-53. https://doi. org/10.1016/j.wneu.2017.09.064 PMid:28935548
  5. Santarius T, Hutchinson PJ. Chronic subdural haematoma: time to rationalize treatment? Br J Neurosurg. 2004;18(4):328–32.
  6. Asghar M, Adhiyaman V, Greenway MW, Bhowmick BK, Bates A. Chronic subdural haematoma in the elderly--a North Wales experience. J R Soc Med. 2002;95(6):290–2.
  7. Shim YS, Park CO, Hyun DK, Park HC, Yoon SH. What are the causative factors for a slow, progressive enlargement of a chronic subdural hematoma? Yonsei Med J. 2007;48(2):210-7. https://doi.org/10.3349/ymj.2007.48.2.210 PMid:17461518
  8. Mehta V, Harward SC, Sankey EW, Nayar G, Codd PJ. Evidence based diagnosis and management of chronic subdural hematoma: A review of the literature. J Clin Neurosci. 2018;50:7-15. https://doi.org/10.1016/j.jocn.2018.01.050 PMid:29428263
  9. Murakami H, Hirose Y, Sagoh M, Shimizu K, Kojima M, Gotoh K, et al. Why do chronic subdural hematomas continue to grow slowly and not coagulate? Role of thrombomodulin in the mechanism. J Neurosurg. 2002;96(5):877-84. https://doi.org/10.3171/jns.2002.96.5.0877PMid:12005395
  10. Delgado-Lopez PD, Martin-Velasco V, Castilla-Diez JM, Rodríguez-Salazar A, Galacho-Harriero AM, Fernández-Arconada O. Dexamethasone treatment in chronic subdural haematoma. Neurocirugia. 2009 Jan 1;20(4):346–59.
  11. Markwalder TM, Steinsiepe KF, Rohner M, Reichenbach W, Markwalder H. The course of chronic subdural hematomas after burr-hole craniostomy and closed-system drainage. J Neurosurg. 1981 Sep;55(3):390–6.
  12. Lee KS, Shim JJ, Yoon SM, Doh JW, Yun IG, Bae HG. Acute-on-chronic subdural hematoma: not uncommon events. Journal of Korean Neurosurgical Society. 2011 Dec;50(6):512.
  13. Lanksch W, Grumme T, Kazner E: Computed Tomography in Head Injuries. Berlin, Springer, 1979.
  14. Cited by: Hoessly GF: Intracranial hemorrhage in the seventeenth century. J Neurosurg 1965; 24:493–496.
  15. Virchow R: Das Hämatom der Dura mater. Verh Phys-Med Ges Würzb 1857;7:134–142.
  16. Gelabert M: Hematoma subdural cro´ nico en el anciano: Revisio´n de una serie de 53 casos. Geriatrika 1987;3:246–249.
  17. Drapkin AJ: Chronic subdural hematoma: Pathophysiological basis for treatment. Br J Neurosurg 1991;5:467–473.
  18. Misra M, Salazar JL, Bloom DM: Subduralperitoneal shunt: Treatment for bilateral chronic subdural hematoma. Surg Neurol 1996;46:378–383.
  19. Hosni Salama. Outcome of single burr hole under local anesthesia in the management of chronic subdural hematoma. Egyptian Journal of Neurosurgery 2019; 34:8 https://doi.org/10.1186/s41984-019-0033-
  20. Jones S, Kafetz K: A prospective study of chronic subdural haematomas in elderly patients. Age Ageing 1999;28:519–521.
  21. Kotwica Z, Brzezinski J: Chronic subdural haematoma treated by burr holes and closed system drainage: Personal experience in 131 patients. Br J Neurosurg 1991;5:461–465.
  22. Robinson RG: Chronic subdural hematoma: Surgical management in 133 patients. J Neurosurg 1984;61:263–268.
  23. Sambasivan M: An overview of chronic subdural hematoma: Experience with 2,300 cases. Surg Neurol 1997;47:418–422.
  24. Zingale A, Albanese V, Romano A, Distefano G, Chiaramonte J: Traumatic chronic subdural hematoma over 80 years: A preliminary prospective study. J Neurosurg Sci 1997;41:169–173.
  25. Hamilton MG, Frizell JB, Tranmer BI: Chronic subdural hematoma: The role for craniotomy reevaluated. Neurosurgery 1993;33: 67–72.
  26. Yadav YR, Parihar V, Namdev H, Bajaj J. Chronic subdural hematoma. Asian Journal of Neurosurgery. 2016 Oct;11 (4):330.
  27. Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir 2001;41(8):371–381.
  28. Erol FS, Topsakal C, Ozveren MF, Kaplan M, Tiftikci MT. Irrigation vs. closed drainage in the treatment of chronic subdural hematoma. J Clin Neurosci. 2005 Apr 1;12 (3):261–3.
  29. Ernestus RI, Beldzinski P, Lanfermann H, Klug N. Chronic subdural hematoma: surgical treatment and outcome in 104 patients. Surg Neurol. 1997 Sep 1;48 (3):220–5.
  30. Tabaddor K, Shulman K. Definitive treatment of chronic subdural hematoma by twist-drill craniostomy and closed-system drainage. J Neurosurg. 1977 Feb;46(2):220–6.
  31. Aung TH, Wong WK, Mo HP, Tsang CS. Management of chronic subdural haematoma: burr hole drainage, replacement with Hartmann's solution, and closed-system drainage. Hong kong medical journal. 1999 Dec;5(4):383–6.
  32. Khadka NK, Sharma GR, Roka YB, Kumar P, Bista P, Adhikari D, Devkota UP. Single burr hole drainage for chronic subdural haematoma. Nepal Med Coll J. 2008 Dec;10(4):254–7.
  33. Miguel Gelabert-Gonza´ lez Elena Lo´ pez-Garcı´a Juan Ferna´ ndez-Villa. Chronic Subdural Hematoma Treated by Burr Holes and Closed Drainage System: A Review of 630 Cases. Med Principles Pract 2001;10:41–47
  34. Aoki N: A new therapeutic method for chronic subdural hematoma in adults: Replacement of the hematoma with oxygen via percutaneous subdural tapping. Surg Neurol 1992;38:253–256.

Corresponding Author

Dr Olabisi O. Ogunleye

Department of Surgery, Abubakar Tafawa Balewa University/Teaching Hospital, Bauchi, Nigeria