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Chronic subdural haematoma — a comparison of two different treatment modalities

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Summary

Burr-hole craniotomy (BHC) and closed-system drainage undoubtedly is currently the most accepted treatment offered in chronic subdural haematoma (CSDH). Although twist-drill trephination (TDT) techniques have been available for years, now a special subdural catheter kit has been launched for treatment of CSDH. In a prospective study, 33 patients with 36 CSDH were treated with a 5-mm TDT regimen and insertion of a CORDIS subdural catheter (CORDIS Corp., Miami, USA). The results are compared with a consecutive series of 33 patients treated previously with an 11-mm BHC and closed-system drainage for 40 CSDH: Recurrence and persistence rate of CSDH treated with TDT necessitating a second intervention was 18.1%, no further surgical intervention was necessary. In BHC treated patients, 33.3% of haematomas had to be reoperated on, another 6.0% had to be re-operated on a third time. Infection rate in BHC treated patients was 18.1% as compared with a 0% infection rate in patients treated with the TDT technique. Mortality rate for the BHC method was 9.0% as compared with 6.0% in the TDT treatment regimen.

Significantly better clinical results are achieved using the TDT technique with insertion of a special subdural catheter, making this procedure superior to the BHC regimen.

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  1. Neurozentrum, Neurochirurgische Universitätsklinik, Freiburg, Federal Republic of Germany

    C. Smely, A. Madlinger & R. Scheremet

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  1. C. Smely
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  2. A. Madlinger
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  3. R. Scheremet
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Smely, C., Madlinger, A. & Scheremet, R. Chronic subdural haematoma — a comparison of two different treatment modalities. Acta neurochir 139, 818–826 (1997). https://doi.org/10.1007/BF01411399

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