Chronic Subdural Hematoma: Drainage vs. No Drainage

Abstract

Objective: To compare the result of chronic subdural hematoma (CSDH) treatment by burr hole with and without closed system drainage in 143 Thai patients at Ramathibodi Hospital. Material and Method: A retrospective study of 143 patients with CSDH treatment at Ramathibodi Hospital between 2002 and 2008 was performed. They underwent burr hole with or without drainage according to the preference of the attending neurosurgeons. The authors compared the result of the two CSDH methods by using CT or MRI of brain post-operatively, complications, recovery condition, mortality rate, and recurrence. Results: Ninety-seven patients were treated with closed system drainage and 46 were treated without drainage. There was no statistical significant distribution in the clinical profiles of both groups. The coagulopathy in both groups might contribute for the recurrence of CSDH while there was no correlation of the recurrence to the other clinical profiles. Fifteen patients (16%) in the drainage group had CSDH recurrence while there were 12 patients (26%) in the no drainage group. Conclusion: Concerning the complete neurological recovery and the recurrence rate of CSDH treatment, there were more complete neurological recovery cases and a lower recurrence rate of CSDH cases in the drainage group but there was no statistical significant difference.