Approach of operative technique in treatment of chronic subdural hematoma / 中国医师进修杂志

ABSTRACT

Objective To approach operative technique for chronic sub, dural hematoma (CSDH).Method The clinical information including general state of health, operative technique and prognosis of the 250 cases with CSDH were retrospectively analyzed. Results Within the 250 cases, 202 were old people with age over 50 and 176 had definite trauma history. In 25 cases treated by burr hole and drainage, 5 cases who had hematoma recurrence and 10 cases who had pneumocephalus, among whom, 6 had tensional pneumoeephalus, were all cured by second operation while the rest got cured. In 207 cases treated by burr hole, douche and drainage, no pneumocephalus or intracranial infection occurred. Twenty of them relapsed and were cured by second operation. Cerebral contusion eccurred in 1 case for pipe was inserted into the brain tissue by mistake, but it got better after active therapy. The other 18 cases were all cured through eraniotomy,hematomas removal as well as envelope excision. Conclusions CSDH is common in the old with age over 50 and it has relationship with head injury,mostly. The single hole trepanation, douche and drainage is simple, safe ,with minimal trauma and high cure rate. To master the operative technique including douching thoroughly, drainage through a pipe and brain protection is very important to the success of the operation.