To Drain or Two Drains: Recurrences in Chronic Subdural Hematomas

Joanna Gernsback, John Paul George Kolcun, Jonathan Jagid

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background Chronic subdural hematoma (cSDH) is a common neurosurgical condition, with an estimated incidence of 3–15.5 per 100,000 people, with significantly higher rates in the elderly population. Recurrence rates range from 2%–37% after surgical drainage. Studies have shown that leaving a drain postoperatively can reduce recurrence rates, but studies have not looked at whether there is a difference between leaving 1 or 2 drains. Methods We analyzed 215 patients undergoing burr hole drainage for 261 cSDHs in terms of preoperative comorbidities and postoperative drain placement. Results Recurrences requiring repeat evacuation occurred in 6.1% overall, in 6/110 patients (5.5%) with 1 burr hole, and in 11/151 patients (7.3%) who had 2 burr holes, which was not significantly different. Recurrences occurred in 1/15 patients (6.7%) with no drain, 13/210 patients (6.2%) with 1 drain, and in 2/36 patients (5.6%) with 2 drains, which was also not statistically significant. The only medical comorbidity associated with an increased risk of recurrence was liver disease (P = 0.014). Conclusions This study demonstrates that neither the number of burr holes nor the number of drains left after a burr hole drainage of cSDH appear to affect recurrence rates, whereas liver disease does make recurrence more likely.

Original languageEnglish (US)
Pages (from-to)2-5
Number of pages4
JournalWorld Neurosurgery
Volume95
DOIs
StatePublished - Nov 1 2016

Keywords

  • Burr hole
  • Chronic subdural hematoma
  • Drain
  • Recurrence

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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