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Evaluating the optimal number of burr-holes for treating chronic subdural haematomas: good results from a single burr-hole?

Neurologia i neurochirurgia polska, 2022-01, Vol.56 (4), p.333-340 [Peer Reviewed Journal]

2022. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 0028-3843 ;EISSN: 1897-4260 ;DOI: 10.5603/PJNNS.a2022.0030 ;PMID: 35467006

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  • Title:
    Evaluating the optimal number of burr-holes for treating chronic subdural haematomas: good results from a single burr-hole?
  • Author: Sánchez Fernández, Carlos ; Jiménez Zapata, Herbet Daniel ; Dueñas Carretero, María ; Fernández García, Adrián ; Amilburu Sáenz, Carla Timisoara ; Jiménez Arribas, Paloma ; Rodríguez Arias, Carlos Alberto
  • Subjects: Hospitals ; Patients
  • Is Part Of: Neurologia i neurochirurgia polska, 2022-01, Vol.56 (4), p.333-340
  • Description: Chronic subdural haematomas (cSDH) are one of the most common types of traumatic intracranial lesion. Burr-hole craniostomy followed by closed-system drainage has become the treatment of choice. However, there is no definitive indication as to the number of burr-holes needed. Our aim was to to assess clinical and radiological outcomes taking into account the number of burr-holes made. A retrospective single-centre-study was performed including patients treated for cSDH by performing burr-hole craniostomy from 2012 to 2018. After collecting data regarding demographics, comorbidities, and clinical and radiological records, haematomas were grouped depending on the number of burr-holes made (Group 1: single burr-hole; Group 2: double burr-holes). Clinical and radiological outcomes were statistically compared between groups, as well as the main complications. After collecting 171 patients, 205 cSDHs were analysed. 173 were treated with a single burr-hole (we called these Group 1) and 32 with double burr-holes (Group 2). No differences in preoperative characteristics were found between the groups, except for diabetes mellitus and previous antiplatelet/anticoagulation treatment. No radiological differences were found regarding haematoma volume (p = 0.7) or thickness (p = 0.3). Surgical site infection (p = 0.13), recurrence (p = 0.6), acute rebleeding (p = 0.25) and mortality (p = 0.94) were assessed without evidencing statistically significant differences. At the time of hospital discharge, most patients showed a remarkable clinical improvement, regardless of the number of burr-holes made (p = 0.7). This study suggests that cSDH can be efficiently evacuated by a single burr-hole craniostomy, a less invasive and shorter surgical procedure with quite good clinical outcomes and a low rate of complications.
  • Publisher: Poland: Wydawnictwo Via Medica
  • Language: English
  • Identifier: ISSN: 0028-3843
    EISSN: 1897-4260
    DOI: 10.5603/PJNNS.a2022.0030
    PMID: 35467006
  • Source: ProQuest One Psychology
    ProQuest Central
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