A Comparison of Subgaleal Active Drainage and Subdural Passive Drainage and an Analysis of Factors Affecting Chronic Subdural Hematoma Outcomes. 2022

Utku Ozgen, and Ilyas Dolas, and Tugrul Cem Unal, and Pulat Akin Sabanci, and Aydin Aydoseli, and Yavuz Aras, and Achmed Ali, and Emrah Keskin, and Kemal Tanju Hepgul
Zonguldak Ataturk State Hospital, Department of Neurosurgery, Zonguldak, Turkey.

OBJECTIVE To analyze and to compare the factors that influence the recurrence of chronic subdural hematoma (CSDH) among patients treated with subdural non-suction-assisted passive drainage, subgaleal suction-assisted active drainage, and without drainage. METHODS We retrospectively evaluated 87 surgical patients with a diagnosis of CSDH treated between 2007 and 2018 using patient records from the neurosurgery archive of our faculty. The patients were divided into three groups: drainfree group (group A), subdural passive drainage group (group B), and subgaleal active drainage group (group C). Recurrence was defined as an increase in hematoma volume on imaging and persistence of the patient?s symptoms. RESULTS Patients with double-membrane CSDH exhibited higher recurrence rates (p=0.043) and those with low-density CSDH exhibited lower recurrence rates (p=0.015) compared to the other patients. No relationship was found between the number of burr holes made and CSDH recurrence (p=0.177). Group C showed the lowest recurrence rate (13.3%), but the differences between groups were not statistically significant. CONCLUSIONS Hematoma density, membrane type, postoperative Glasgow Outcome Scale scores, and postoperative drainage time were found to be statistically significant predictors of recurrence. Burr-hole craniotomy with subgaleal active drainage is a safe and effective method for preventing CSDH recurrence and carries a reduced risk of parenchymal injury.

UI MeSH Term Description Entries
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D003399 Craniotomy Surgical incision into the cranium. Craniectomy,Craniectomies,Craniotomies
D004322 Drainage The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D006406 Hematoma A collection of blood outside the BLOOD VESSELS. Hematoma can be localized in an organ, space, or tissue. Hematomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014207 Trephining The removal of a circular disk of the cranium. Trepanation,Trepanning,Trephination,Trepanations,Trepannings
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D020200 Hematoma, Subdural, Chronic Accumulation of blood in the SUBDURAL SPACE with delayed onset of neurological symptoms. Symptoms may include loss of consciousness, severe HEADACHE, and deteriorating mental status. Hemorrhage, Subdural, Chronic,Subdural Hematoma, Chronic,Chronic Subdural Hematoma,Chronic Subdural Hematomas,Hematoma, Chronic Subdural,Hematomas, Chronic Subdural,Subdural Hematomas, Chronic

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