Intraoperative Irrigation and Risk of Chronic Subdural Hematoma Recurrence

Anders Schack*, Thorbjørn Søren Rønn Jensen, Mette Haldrup Jensen, Rares Miscov, Ann Kathrine Sindby, Kåre Fugleholm, Bo Bergholt, Carsten Reidies Bjarkam, Frantz Rom Poulsen, Mads Hjortdal Grønhøj

*Corresponding author for this work

Abstract

BACKGROUND AND OBJECTIVES: In most neurosurgical centers, irrigation is an essential part of the surgical procedure for chronic subdural hematoma (CSDH). However, it is unknown whether the volume of irrigation fluid affects the risk of CSDH recurrence. This study aimed to investigate a potential association between the volume of irrigation fluid used during burr hole evacuation of CSDH and the risk of CSDH recurrence.

METHODS: This study is a subanalysis of 2 randomized trials (Drain Time & Drain Time 2) designed to investigate the effect of drainage duration on the recurrence of CSDH. Intraoperative irrigation volume was measured, and patients were followed for 90 days for recurrent CSDH.

RESULTS: A total of 525 patients with CSDH were included. There was no significant difference in the volume of irrigation fluid used between patients with recurrence (mean = 938 mL, SD = ±552) and without recurrence (mean = 852 mL, SD = ±454) (P-value = .15). Patients with recurrent CSDH had larger primary CSDH volumes (mean = 134 cm3, SD = ±69) than patients without recurrence (mean = 119 cm3, SD = ±58) (P = .04). Multiple logistic regression analysis revealed no association between irrigation volume and recurrence, also when stratified for hematoma size.

CONCLUSION: There was no significant association between irrigation volume and recurrent CSDH within 90 days in patients undergoing burr hole surgery for CSDH.

Original languageEnglish
JournalOperative Neurosurgery
Volume26
Issue number2
Pages (from-to)203-212
Number of pages10
ISSN2332-4252
DOIs
Publication statusPublished - 2024

Keywords

  • Craniotomy/methods
  • Drainage/methods
  • Hematoma, Subdural, Chronic/surgery
  • Humans
  • Trephining/methods

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