TITLE:
Minimal Access Surgical Evacuation of Unilateral Chronic Subdural Hematoma
AUTHORS:
Hamdy Mohammed Behairy
KEYWORDS:
Chronic Subdural Hematoma, Burr-Hole Evacuation
JOURNAL NAME:
World Journal of Neuroscience,
Vol.8 No.1,
February
1,
2018
ABSTRACT: Chronic subdural hematoma (CSDH) is one of the most
common neurosurgical conditions occurring mostly in elderly and ideally treated
with surgical drainage. Many surgical techniques of different degrees of
invasiveness have been proposed for its treatment with controversy about the
best surgical procedure. The study aims to evaluate the efficacy of the minimal
access technique of single burr-hole craniostomy and massive irrigation for
treatment of unilateral CSDH. The study is a prospective descriptive study
involved all patients with symptomatic radiologically proven unilateral CSDH
admitted and treated surgically in department of Neurosurgery, Al-Hussein
University hospital, Al-Azhar University, Cairo, Egypt, over 3 years, from
January 2013 to January 2016. In the results we found that total 64 patients of
CSDH, treated surgically by this procedure. Men formed 72% and women 28%. Age
range was 51 to 82 years; the mean age was 65 years. Clinical presentation was
impaired consciousness in 7%, headache (59%), right hemiparesis in 56% and left
hemiparesis in 37%. CT was done for 91% and MRI 27% patients. The hematoma was
left in 61% and right in 39%. Surgical evacuation utilizing this procedure was
done in all patients. Complete recovery was obtained in 82% of patients and
partial recovery in 11% of patients. Follow up for 4 months was done.
Recurrence was detected in 6% of patients. We concluded that unilateral CSDH
can be treated effectively by single nondependent burr-hole craniostomy and
massive irrigation with excellent outcome.