Skip to main content
Log in

Continuous irrigation-drainage of the subdural space for the treatment of chronic subdural haematoma. A prospective clinical trial

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Thirty seven adult patients which chronic subdural haematoma were randomized into two groups. Eighteen patients served as controls and underwent evacuation of the haematoma via burr holes and a gravity dependent closed-system drainage. Nineteen patients comprised the study group. These patients had a continuous irrigation-drainage system installed in an attempt to facilitate the removal of fibrinolytic substances present in the haematoma fluid and to try to reduce the rate of rebleeding from the haematoma membranes. No differences were found between the pre- and post-operative clinical status, haematoma volumes and the degree of CT changes between the two groups. The complication rate was similar in the two groups. One patient in the study group and three patients in the control group required an extended period of drainage (24–48 hours) prior to the removal of the drains. All patients improved following the procedures. Within 30 days post the initial evacuation of the chronic subdural haematoma, re-operation was required in only one patient in the study group as opposed to four of the controls. This difference was not however statistically significant. When the need for re-operation was combined with the need for extended drainage period, a significant difference was shown in favour of the study group. These results indicate that drainage combined with continuous irrigation of the subdural space does not affect the clinical outcome of the patients, but significantly reduces the frequency of inadequate drainage of the haematoma and prevents longer drainage periods and repeated operations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fogelholm R, Waltimo O (1975) Epidemiology of chronic subdural haematoma. Acta Neurochir (Wien) 32: 247–250

    Article  Google Scholar 

  2. Ito H, Komai T, Yamamoto S (1975) Fibrin and fibrinogen degradation products in chronic subdural haematoma. Neurol Med Chir (Tokyo) 15: 51–55

    Google Scholar 

  3. Ito H, Yamamoto S, Komai T, Mizukoshi H (1976) Role of local hyperfibrinolysis in the etiology of chronic subdural haematoma. J Neurosurg 45: 26–31

    PubMed  Google Scholar 

  4. Ito H, Komai T, Yamamoto S (1978) Fibrinolytic enzyme in the lining walls of chronic subdural haematoma. J Neurosurg 48: 197–200

    PubMed  Google Scholar 

  5. Ito H, Saito K, Yamamoto S, Hasegawa T (1988) Tissue-type plasminogen activator in the chronic subdural haematoma. Surg Neurol 30: 175–179

    Article  PubMed  Google Scholar 

  6. Labadie EL, Glover D (1975) Local alterations of haemostaticfibrinolytic mechanisms in reforming subdural haematomas. Neurology 25: 669–675

    PubMed  Google Scholar 

  7. Loew F (1982) Management of chronic subdural haematomas and hygromas. In: Krayenbühlet al (eds) Advances and technical standards in neurosurgery, Vol 9. Springer, Wien New York, pp 113–131

    Google Scholar 

  8. Markwalder TM, Reulen HJ (1986) Influence of neomembranous organisation, cortical expansion and subdural pressure on the post-operative course of chronic subdural haematoma — an analysis of 201 cases. Acta Neurochir (Wien) 79: 100–106

    Article  Google Scholar 

  9. Spiegelman R (1988) A simple method for irrigation and drainage in neurosurgery. Acta Neurochir (Wien) 93: 68–69

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ram, Z., Hadani, M., Sahar, A. et al. Continuous irrigation-drainage of the subdural space for the treatment of chronic subdural haematoma. A prospective clinical trial. Acta neurochir 120, 40–43 (1993). https://doi.org/10.1007/BF02001467

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02001467

Keywords

Navigation