Objective： To investigate the treatment of chronic subdural hematoma （CSDH） with burr-hole craniotomy in our hospital. Methods： From January 2004 to December 2009, 398 patients with CSDH, 338 males and 60 females...Objective： To investigate the treatment of chronic subdural hematoma （CSDH） with burr-hole craniotomy in our hospital. Methods： From January 2004 to December 2009, 398 patients with CSDH, 338 males and 60 females （male/ female=5.63/1）, received burr-hole craniotomy in our hospital. The median age was 60 years with the mean age of （58.1± 18.1） years, （65.0±14.5） years for females and （57.0± 8.2） years for males. Trauma history was determined in 275 patients （69.1%）. Burr-hole craniotomy was performed under local anesthesia in 368 patients and general anesthesia in 30 patients. CSDH was classified into 3 groups according to the density on CT scan. Clinical data concerning etiologies, symptoms and signs, concomitant diseases, diagnosis, therapies and outcomes were investigated retrospectively. Patients＇ neu- rological status on admission and at discharge was also classified to judge the outcomes. Results： Generally, trauma history showed few dif- ferences between those over 60 years old and under 60 years old, but showed obvious differences when gender was taken into account. Totally 123 male patients （60.0% of 204 cases） suffering from head injuries were under 60 years, whereas 35 female patients （85.4% of 41 cases） with trauma histories were over 60 years. The duration from trauma to appearance of clinical symptoms was （84.0±61.7） days （range, 0-1493 days）. Traumatic accident was the leading etiology, other accompanying diseases such as cerebral vascular disease, hypertension, etc, were also predisposing factors. Commonly, the elderly presented with hemiplegia/ hemidysesthesia/hemiataxia and the young with headache. Most CSDH patients （95.6%） treated with burr-hole cran- iotomy successfully recovered. However, postoperative complications occurred in 17 cases, including recurrence of CSDH in 15 cases, subdural abscess in 1 case and pneumonia in 3 cases. Conclusion： Burr-hole craniotomy is an easy, efficient and reliable way to treat CSDH.展开更多
Objective： of chronic subdural hematoma The surgical management （CSDH） is still a controversial issue, and a standard therapy has not been established because of the unclear pathogenic mechanisms in CSDH. The inten...Objective： of chronic subdural hematoma The surgical management （CSDH） is still a controversial issue, and a standard therapy has not been established because of the unclear pathogenic mechanisms in CSDH. The intention of this paper is to find a simple and efficient surgical procedure for CSDH. Methods： A retrospective study of 448 patients with CSDH by surgical treatment during 2005 to 2009 was conducted in order to compare the efficiency between two diferent primary surgical methods, i.e. twist-drill drainage without irrigation in Group A （n-178） and one burr-hole with irrigation in Group B （n=270）. The results were statistically analyzed. Results： The reoperation rates in Group A and Group B were 7.9% and 11.9% respectively. The good outcome rate was 88.8% and 73.5%, the complicatiGn was 7.9% and 20.7% in Group A and Group B, respectively. Conclusions： The burr-hole drainage with irrigation of the hematoma cavity is not beneficial to the outcome and prognosis. Irrigation is not important in the surgical treatmerit for CSDH. Thus in initial treatment, twist-drill drainage without irrigation of the hematoma cavity is recommended because it is relatively safe, time-saving and cost-effective.展开更多
文摘Objective： To investigate the treatment of chronic subdural hematoma （CSDH） with burr-hole craniotomy in our hospital. Methods： From January 2004 to December 2009, 398 patients with CSDH, 338 males and 60 females （male/ female=5.63/1）, received burr-hole craniotomy in our hospital. The median age was 60 years with the mean age of （58.1± 18.1） years, （65.0±14.5） years for females and （57.0± 8.2） years for males. Trauma history was determined in 275 patients （69.1%）. Burr-hole craniotomy was performed under local anesthesia in 368 patients and general anesthesia in 30 patients. CSDH was classified into 3 groups according to the density on CT scan. Clinical data concerning etiologies, symptoms and signs, concomitant diseases, diagnosis, therapies and outcomes were investigated retrospectively. Patients＇ neu- rological status on admission and at discharge was also classified to judge the outcomes. Results： Generally, trauma history showed few dif- ferences between those over 60 years old and under 60 years old, but showed obvious differences when gender was taken into account. Totally 123 male patients （60.0% of 204 cases） suffering from head injuries were under 60 years, whereas 35 female patients （85.4% of 41 cases） with trauma histories were over 60 years. The duration from trauma to appearance of clinical symptoms was （84.0±61.7） days （range, 0-1493 days）. Traumatic accident was the leading etiology, other accompanying diseases such as cerebral vascular disease, hypertension, etc, were also predisposing factors. Commonly, the elderly presented with hemiplegia/ hemidysesthesia/hemiataxia and the young with headache. Most CSDH patients （95.6%） treated with burr-hole cran- iotomy successfully recovered. However, postoperative complications occurred in 17 cases, including recurrence of CSDH in 15 cases, subdural abscess in 1 case and pneumonia in 3 cases. Conclusion： Burr-hole craniotomy is an easy, efficient and reliable way to treat CSDH.
文摘Objective： of chronic subdural hematoma The surgical management （CSDH） is still a controversial issue, and a standard therapy has not been established because of the unclear pathogenic mechanisms in CSDH. The intention of this paper is to find a simple and efficient surgical procedure for CSDH. Methods： A retrospective study of 448 patients with CSDH by surgical treatment during 2005 to 2009 was conducted in order to compare the efficiency between two diferent primary surgical methods, i.e. twist-drill drainage without irrigation in Group A （n-178） and one burr-hole with irrigation in Group B （n=270）. The results were statistically analyzed. Results： The reoperation rates in Group A and Group B were 7.9% and 11.9% respectively. The good outcome rate was 88.8% and 73.5%, the complicatiGn was 7.9% and 20.7% in Group A and Group B, respectively. Conclusions： The burr-hole drainage with irrigation of the hematoma cavity is not beneficial to the outcome and prognosis. Irrigation is not important in the surgical treatmerit for CSDH. Thus in initial treatment, twist-drill drainage without irrigation of the hematoma cavity is recommended because it is relatively safe, time-saving and cost-effective.
