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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(01): 070-074
DOI: 10.1055/s-0043-1761232
Original Article

Validating the Efficacy of Two Burr-Hole Craniostomy over Mini-Craniotomy for Chronic Subdural Hematoma Drainage

Pranoy Hegde 
1   Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
,
Bharat Nayak
1   Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
,
Aditya Madishetty
1   Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
,
Parichay J. Perikal
1   Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
,
Sunil V. Furtado
1   Department of Neurosurgery, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India
› Author Affiliations Funding None.
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Abstract

Background There is an increasing incidence of chronic subdural hematoma due to extended life expectancy and associated trauma and fall risk. This retrospective study evaluates the efficacy of two burr-hole craniotomy over mini-craniotomy.

Methods Sixty-five patients were recruited over 2 years, of which 56 were male and 9 were females. A patient with a chronic subdural hematoma either underwent burr-hole craniostomy or mini-craniotomy for hematoma evacuation. Glasgow coma scale (GCS) and modified Rankin score were used to assess the neurological status and interventional outcome at discharge and follow-up, respectively. A head CT scan was performed at 3 week and 3 month follow-up.

Statistical Analysis Categorical data are presented as frequency and percentage, while non-categorical data are represented as mean ± SD. Statistical significance for difference in outcome between the two groups was analyzed using the chi-square test and p-value less than 0.05 was considered statistically significant.

Results The mean age of patients was 55.6 years. Headache (35 cases), hemiparesis, and altered sensorium were seen in 20 patients, each with the main presenting symptoms. Trauma history was noted in 69.2% of patients. One (3.7%) hematoma recurrence in the burr-hole group and four (8.3%) in the mini-craniotomy group was recorded. The mean operative time was longer in the minicraniotomy group (124.2 min vs. 75.4 min; p < 0.001). A higher incidence of recurrence was noted in the craniotomy group (8.3%) than the burr-hole group (3.7%). No statistical difference in the recurrence rate, duration of hospital stay, GCS at discharge, modified Rankin score between the two study groups at discharge was noted.

Conclusion Two burr-hole craniostomy is a safe and effective surgical option to treat chronic subdural hematoma. It is also validated in patients on anticoagulants and antiplatelet medications with adequate pre-surgical correction of coagulation parameters.

Keywords

burr-hole - chronic subdural hematoma - craniotomy - membrane - recurrence


Publication History

Article published online:
27 March 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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