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Burr hole craniostomy versus minicraniotomy in chronic subdural hematoma: a comparative cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  • Shaian Zolfaghari
  • Jiri Bartek
  • Isabelle Strom
  • Felix Djärf
  • San-San Wong
  • Nils Ståhl
  • Asgeir S Jakola
  • Henrietta Nittby Redebrandt
Vis graf over relationer

BACKGROUND: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases. In surgical management of CSDH, there is a lack of standardized guidelines concerning surgical techniques and a lack of consensus on which technique(s) are optimal. Neurosurgical centers have shown a wide variation in surgical techniques. The purpose of this study was to compare two different surgical techniques, one burr hole craniostomy with an active subgaleal drain (BHC) and minicraniotomy with a passive subdural drain (MC).

METHODS: We conducted a multicenter retrospective cohort study at two neurosurgical centers in Sweden which included patients with unilateral CSDHs that received surgical treatment with either BHC or MC. The primary outcomes in comparison of the techniques were 30-day mortality, recurrence rate, and complications according to the Landriel Ibañez grading system for complications.

RESULTS: A total of 1003 patients were included in this study. The BHC subgroup included 560 patients, and the MC subgroup included 443 patients. A 30-day mortality when comparing BHC (2.3%) and MC (2.7%) was similar (p = 0.701). Comparing recurrence rate for BHC (8.9%) and MC (10.8%) showed no significant difference (p = 0.336). We found that medical complications were significantly more common in the MC group (p = 0.001). Surgical complications (type IIb) was also associated with the MC group (n = 10, p = 0.003). Out of the 10 patients with type IIb complications in the MC group, 8 had postoperative acute subdural hematomas.

CONCLUSIONS: BHC was comparable to MC concerning 30-day mortality rate and recurrence rates. We did, however, find that MC was significantly associated with medical complications and serious surgical postoperative complications.

OriginalsprogEngelsk
TidsskriftActa Neurochirurgica
Vol/bind163
Udgave nummer11
Sider (fra-til)3217-3223
Antal sider7
ISSN0001-6268
DOI
StatusUdgivet - nov. 2021

ID: 66955878