#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#
preLekára.sk / Journals / Perspectives in Surgery / 2020 - 1

Is there an impact of subdural drainage duration and the number of burr holes on the recurrence rate of unilateral chronic subdural haematoma?

Česká verzia

Authors: R. Opšenák;  T. Fejerčák;  M. Hanko;  P. Snopko;  K. Varga;  R. Richterová;  B. Kolarovszki
Authors place of work: Neurochirurgická klinika Jesseniovej lekárskej fakulty v Martine, Univerzity Komenského v Bratislave, Univerzitná nemocnica Martin
Published in the journal: Rozhl. Chir., 2020, roč. 99, č. 1, s. 29-33.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2020.99.1.29–33

Summary

Introduction: Purpose of the study is to evaluate a possible influence of subdural drainage duration and burr hole quantity on a relapse of a unilateral chronic subdural haematoma (CHSH).

Methods: Sixty - five patients who underwent evacuation of unilateral CHSH via 1 or 2 burr holes and subdural drainage during a period from January 2014 to December 2018 were retrospectively analyzed. Duration of the subdural drainage and the number of burr holes used were assessed in relation to an incidence of CHSH recurrence. According to the subdural drainage duration, we divided the patient cohort into two subgroups: with the subdural drainage duration of 1–3 days and 4–5 days. We also evaluated a possible influence of the subdural drainage duration on risk of postoperative infection.

Results: An overall incidence of CHSH recurrence was 18.5%. In 45 patients treated by means of a single burr hole the haematoma recurrence was observed in 10 patients (22.2%), in 22 patients with two burr holes recurrence occurred in 2 of them (9.1%). The difference was however, not statistically significant (p=0.3214). We did not observe any significant influence of age, gender and subdural drainage duration on the incidence of CHSH recurrence. The duration of subdural drainage had not significant impact on postoperative infection rate (p=0.0950).

Conclusion: The number of burr holes used does not affect the rate of unilateral CHSH recurrence. Similarly the duration of subdural drainage affects neither the unilateral CHSH recurrence rate nor the incidence of postoperative infection.

Keywords:

risk factors – chronic subdural haematoma – recurrence – subdural drainage – burr hole – postoperative infection

Zdroje
  1. Altaf I, Shams S, Vohra AH. Radiolological predictors of recurrence of chronic subdural hematoma. Pak J Med Sci. 2018;34(1):194–197. doi: 10.12669/pjms.341.13735.
  2. You W, Zhu Y, Wang Y, et al. Prevalence of and risk factors for recurrence of chro­nic subdural hematoma. Acta Neurochir. (Wien) 2018;160(5):893–899. doi: 10.1007/s00701-018-3513-0.
  3. Motoie R, Karashima S, Otsuji R, et al. Recurrence in 787 patients with chronic subdural hematoma: Retrospective cohort investigation of associated factors including direct oral anticoagulant use. World Neurosurg. 2018;118:87–91. doi: 10.1016/j.wneu.2018.06.124. 
  4. Glancz LJ, Poon MTC, Coulter IC, et al. Does drain position and duration influence outcomes in patients undergoing burr-hole evacuation of chronic subdural hematoma? Lessons from a UK multicenter prospective cohort study. Neurosurgery 2018;29. doi: 10.1093/neuros/nyy366. 
  5. Goyal RK, Nayak B, Maharshi R, et al. Management of chronic subdural hematoma: Burr hole versus twist drill - a prospective study. Asian J Neurosurg. 2018;13(2):319–323. doi: 10.4103/ ajns.AJNS_99_16.
  6. Yan C, Yang MF, Huang YW. A reliable nomogram model to predict the recurrence of chronic subdural hematoma after burr hole surgery. World Neurosurg. 2018;118:356-366. doi: 10.1016/j.wneu.2018.06.191.
  7. Hammer A, Tregubow A, Kerry G, et al. Predictors for recurrence of chronic subdural hematoma. Turk Neurosurg. 2017;27(5):756–762. doi: 10.5137/1019-5149.JTN.17347-16.1.
  8. Liu W, Bakker NA, Groen RJ. Chronic subdural hematoma: a systematic review and meta-analysis of surgical procedures. J Neurosurg. 2014;121(3):665–73. doi: 10.3171/2014.5.JNS132715.
  9. Tomita Y, Yamada SM, Yamada S, et al. Subdural tension on the brain in patients with chronic subdural hematomas related to hemiparesis but not to headache or recurrence. World Neurosurg. 2018;119:518–526. doi: 10.1016/j.wneu.2018.07.192. 
  10. Stavrinou P, Katsigiannis S, Lee JH, et al. Risk factors for chronic subdural hematoma recurrence identified using quantitative computed tomography analysis of hematoma volume and density. World Neurosurg. 2017;99:465–470. doi: 10.1016/j.wneu.2016.12.058. 
  11. Santarius T, Kirkpatrick PJ, Ganesan D, et al. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet 2009 26;374(9695):1067–1073. doi: 10.1016/S0140-6736(09)61115-6.
  12. Soleman J, Kamenova M, Lutz K, et al. Drain insertion in chronic subdural hematoma: An international survey of practice. World Neurosurg. 2017;104:528–536. doi: 10.1016/j.wneu.2017.04.134.
  13. Kale A, Oz II, Gun EG, et al. Is the recurrence rate of chronic subdural hematomas dependent on the duration of drainage? Neurol Res. 2017;39(5):399–402. doi: 10.1080/01616412.2017.1296655.
  14. Heringer LC, Sousa UO, Oliveira MF, et al. The number of burr holes and use of a drain do not interfere with surgical results of chronic sudbural hematomas. Arq Neuropsiquiatr. 2017;75(11):809–812. doi: 10.1590/0004-282X20170136.
  15. Taussky P, Fandino J, Landolt H. Number of burr holes as independent predictor of postoperative recurrence in chronic subdural haematoma. Br J Neurosurg. 2008;22(2):279–82. doi: 10.1080/02688690701818885.
  16. Yu GJ, Han CZ, Zhang M, et al. Prolonged drainage reduces the recurrence of chronic subdural hematoma. Br J Neurosurg. 2009;23(6):606–611. doi: 10.3109/02688690903386983.
  17. You CG, Zheng XS. Postoperative pneumocephalus increases the recurrence rate of chronic subdural hematoma. Clin Neurol Neurosurg. 2018;166:56–60. doi: 10.1016/j.clineuro.2018.01.029.
  18. Snopko P, Kolarovszki B, Opsenak R, et al. Chronic calcified subdural hematoma - case report of a rare diagnosis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019. doi: 10.5507/bp.2019.041. [Epub ahead of print]
  19. Kaiser R, Houšťava L, Mencl L, et al. Organizovaný chronický subdurální hematom – kazuistiky. Cesk Slov Neurol N. 2011;74/107(3):353–356.
  20. Kocaman U, Yilmaz H. Description of a modified technique (mini craniotomy-basal membranotomy) for chronic subdural hematoma surgery and evaluation of the contribution of basal membranotomy performed as part of this technique to cerebral Expansion. World Neurosurg. 2019;122:1002–1006. doi: 10.1016/j.wneu.2018.10.196.
  21. Opsenak R, Hanko M, Snopko P, et al. Factors influencing the results of surgical therapy of non-acute subdural haematomas. Eur J Trauma Emerg Surg. 2019. [Epub ahead of print]. https://doi.org/10.1007/s00068-019-01258-3.
  22. Haron S, Bogduk N, Hansen M. A retrospective analysis of chronic subdural haematoma recurrence rates following burr hole trephination versus minicraniotomy. J Clin Neurosci. 2019;59:47–50. doi: 10.1016/j.jocn.2018.11.009.
  23. Ishfaq A. Outcome in chronic subdural hematoma after subdural vs. subgaleal drain. J Coll Physicians Surg Pak. 2017;27(7):419–422. doi: 2656.
  24. Soleman J, Lutz K, Schaedelin S, et al. Subperiosteal vs subdural drain after burr-hole drainage of chronic subdural hematoma: A randomized clinical trial (cSDH-Drain-Trial). Neurosurgery 2019;85(5):825–834. doi: 10.1093/neuros/nyz095.
  25. Zhang JJY, Wang S, Foo ASC, et al. Outcomes of subdural versus subperiosteal drain after burr-hole evacuation of chronic subdural hematoma: A multicenter cohort study. World Neurosurg. 2019;131: 392–401. [Epub 2019 Jul 30]. doi: 10.1016/j.wneu.2019.07.168.
  26. Kim YS, Joo SP, Song DJ, et al. Delayed intracranial subdural empyema following burr hole drainage: Case series and literature review. Medicine (Baltimore). 2018;97(18):0664. doi: 10.1097/MD.0000000000010664.
  27. Yuan Y, Wang QP, Cao YL, et al. Burr hole drainage and burr hole drainage with irrigation to treat chronic subdural hematoma: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97(33):11827. doi: 10.1097/MD.0000000000011827.
  28. Stejskal P, Vaverka M, Hrabálek L, et al. Je nutné při operační léčbě chronického subdurálního hematomu trepanací a drenáží provádět i výplach hematomu? Cesk Slov Neurol N. 2019;82(4):448–451.
  29. Majovsky M, Masopust V, Netuka D, et al. Flexible endoscope-assisted evacuation of chronic subdural hematomas. Acta Neurochir (Wien). 2016;158(10):1987–1992. doi: 10.1007/s00701-016-2902-5.
Štítky
Surgery Orthopaedics Trauma surgery
Článek A review of possible complications in patients after decompressive craniectomy
Článek History, development and use of classification of thoracolumbar spine fractures
Článek Atlanto-occipital dissociation
Článek Příležitosti k řezu i k hojení
Článek Instrumentation of C1 lateral mass via insertion of the posterior arch of atlas – a morphometric study
Článek Use of nuclear medicine methods in surgical treatment of lumbar spine degeneration
Článek Transpedikulární fixace s augmentovanými fenestrovanými šrouby u osteoporotických fraktur páteře
Článek Téma chronického subdurálneho hematómu v článkoch českých a slovenských autorov
Článok vyšiel v časopise

Perspectives in Surgery

Číslo 1
2020 Číslo 1
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#