Comparing twist-drill drainage with burr hole drainage for chronic subdural hematoma

ObjectiveThe surgical management of chronic subdural hematoma (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.MethodsA retrospective study of 448 patients with CSDH by surgical treatment during 2005 to 2009 was conducted in order to compare the efficiency between two different primary surgical methods, i.e. twist-drill drainage with-out irrigation in Group A (n=178) and one burr-hole with irrigation in Group B (n=270). The results were statistically analyzed.ResultsThe reoperation rates in Group A and Group B were 7.9% and 11.9% respectively. The good outcome rate was 88.8% and 75.5%, the complication was 7.9% and 20.7% in Group A and Group B, respectively.ConclusionsThe burr-hole drainage with irrigation of the hematoma cavity is not beneficial to the outcome and prognosis. Irrigation is not important in the surgical treatment for C S D H. 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.