Quick Search:

uzh logo
Browse by:
bullet
bullet
bullet
bullet

Zurich Open Repository and Archive

Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-28343

Zumofen, D; Regli, L; Levivier, M; Krayenbühl, N (2009). Chronic subdural hematomas treated by burr-hole trepanation and subperiostal drainage system. Neurosurgery, 64(4):1116-1121.

[img]
Preview
Accepted Version
PDF
1MB

View at publisher

Abstract

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.

Citations

Altmetrics

Downloads

291 downloads since deposited on 16 Jul 2010
58 downloads since 12 months

Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
DDC:610 Medicine & health
Language:English
Date:June 2009
Deposited On:16 Jul 2010 14:45
Last Modified:28 Nov 2013 01:07
Publisher:Lippincott Wiliams & Wilkins
ISSN:0148-396X
Additional Information:This is a non-final version of an article published in final form in Neurosurgery. 2009 Jun;64(6):1116-21
Publisher DOI:10.1227/01.NEU.0000345633.45961.BB
PubMed ID:19487891

Users (please log in): suggest update or correction for this item

Repository Staff Only: item control page