Background: Chronic subdural hematoma (CSDH) is seen most common in geriatric patients, and trauma
is the most important reason for CSDH. Operative treatment of CSDH in symptomatic
patients is yet the gold standard of therapy because it allows decompression of the
subdural space and aids improvement in neurological status. Burr-hole craniostomy
is the most common accepted treatment for CSDH. There is still controversy regarding
which type of drain placement is best in the outcome: subdural or subgaleal drain.
Aim: The aim of the study was to compare the outcome of subgaleal versus subdural drain
in surgically treated patients of CSDH. Materials and Methods: Patients were assigned by simple random sampling in two groups. The study was conducted
from February 2016 to July 2017. A total of 70 patients were enrolled into the study
and were divided in two groups (Group 1 – Subgaleal drain; Group 2 – Subdural drain).
Statistical analysis was done using Chi-square and t-test. Outcome was assessed at
the end of hospital stay by modified Rankin scale. Postoperative computed tomography
scan was done after 24 h of surgery. Results: This study concluded that both types of drains are equally effective for the treatment
of CSDH. There is a statistically significant difference in the occurrence of seizure
in both the groups as there was no seizure in subgaleal drain group compared to 5
(14.3%) patients who had seizures postoperatively in subdural drain group (P = 0.020).
There was insignificant difference with respect to preoperative Glasgow Coma Scale/sex/preoperative
hematoma volume/postoperative hematoma volume/preoperative midline shift. Conclusion: Subgaleal drain is safe and technically easy, as subgaleal drain has no direct contact
with brain parenchyma, thus less chances of brain laceration, intracerebral hematoma
formation, and seizures.
Key-words:
Burr hole - chronic subdural hematoma - seizures - subdural drain - subgaleal drain
