Clinical and surgical outcomes of chronic subdural hematoma treated using a single burr hole and closed drainage system without irrigation in adult patients

Abstract

Background: Accumulation of blood between dura mater and arachnoid membrane is known as Chronic subdural hematoma (CSDH) which is a common neurological condition. Using a single burr hole and closed drainage system this study shows the clinical and surgical outcomes of CSDH.

Methods: A total of 23 patients diagnosed with CSDH over a period of 2 years were included in our study that was carried out at our institution. Patients’ demographic, preoperative symptoms and post-operative were recorded. All patients underwent single burr hole craniotomy with continuous passive drainage using a Foley catheter. Data was analyzed using SPSS version 25.

Results: A total of 23 patients were included in this study. Out of the total, 20 were males (87%) and 3 were females (13%) with the age ranging from 18 to 75 years (mean 54.3 years). Pre-operative symptoms included headache (78.3%), hemiparesis (65.2%), falling tendency (52.2%), disturbed sensorium (47.8%) and incoherent speech (39.1%). The postoperative recovery was significant with 95.65% of patients being completely symptom free. Only one patient (4.35%) had recurrence that responded well with reoperation. No case was complicated with pneumocephalus, infection, or rebleeding, which endorses this technique as both safe and effective.

Conclusion: The single burr hole with a closed drainage system without irrigation is a safe, effective and minimally invasive technique for treating CSDH. Its simplicity cost effectiveness and favorable outcomes make it an ideal option particularly in resource limited settings. Future research with larger sample sizes is recommended to validate these findings and assess long-term outcomes.