Chronic subdural hematomas treated by burr hole trepanation and a subperiostal drainage system.

Détails

ID Serval
serval:BIB_C84F3D25E751
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Chronic subdural hematomas treated by burr hole trepanation and a subperiostal drainage system.
Périodique
Neurosurgery
Auteur(s)
Zumofen D., Regli L., Levivier M., Krayenbühl N.
ISSN
1524-4040[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
64
Numéro
6
Pages
1116-1122
Langue
anglais
Résumé
OBJECTIVE: Most symptomatic chronic subdural hematomas are treated by subdural drainage. However, a subperiostal (i.e., extracranial) passive closed-drainage system in combination with double burr hole trepanation is used at our institution. Therefore, we wanted to analyze our results and compare them with the alternate treatment strategies reported in the current literature. METHODS: In a retrospective single-center study, we analyzed the data of all patients undergoing double burr hole trepanation with a subperiostal passive closed-drainage system. Data analysis included general patient data, complications, postoperative seizure rate, and outcome. RESULTS: One hundred forty-seven patients underwent surgery for 183 symptomatic chronic subdural hematomas. The perioperative mortality rate was 3.4%. Hematoma persistence or recurrence occurred in 13.1% of the cases. The postoperative seizure rate was 6.6%, and the infection rate was 1.6%, including 3 cases of superficial wound infection and 1 case with deep infection. The reintervention rate was 9.3%, including trepanation in 8.2% of the patients and craniotomy in 1.1%. The overall complication rate was 10.9%. CONCLUSION: Double burr hole trepanation combined with a subperiostal passive closed-drainage system is a technically easy, highly effective, safe, and cost-efficient treatment strategy for symptomatic chronic subdural hematomas. The absence of a drain in direct contact with the hematoma capsule may moderate the risk of postoperative seizure and limit the secondary spread of infection to intracranial compartments.
Mots-clé
Craniotomy/adverse effects, Craniotomy/methods, Drainage/adverse effects, Drainage/methods, Hematoma, Subdural, Chronic/surgery, Humans, Neurosurgical Procedures/adverse effects, Neurosurgical Procedures/methods, Postoperative Complications, Recurrence, Retrospective Studies, Treatment Outcome
Pubmed
Web of science
Création de la notice
03/09/2009 13:27
Dernière modification de la notice
20/08/2019 16:43
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