Clinical study of drainage catheter location during treatment of chronic subdural hematoma / 中华创伤杂志

ABSTRACT

Objective To determine the best position of the catheter to achieve a low recurrence rate during subdural drainage for chronic subdural hematoma (CSDH). Methods A retrospective study was done on 130 cases with CSDH in regard of preoperative thickness of CSDH, preoperative midline displacement, postoperative locations (forehead, temple, cupula and occiput) of the subdural drainage catheter, postoperative width of the subdural space and the relationship of the accumulated air in ipsilateral subdural space with postoperative relapse. Results The CSDH thickness and the midline displacement on preoperative CT scan had no correlation with the postoperative recurrence rate of CSDH. Seven days after operation, the width of the subdural space over 1 cm or the accumulated air of the subdural space exceeding 20% of the the subdural space volume would result in obvious increase of recurrence rate of CSDH. The catheter locating on the frontal lobe cortex postoperatively had the lowest recurrence rate of CSDH. Conclusions Postoperative recurrence of CSDH can be reduced by placing the tip of the drainage catheter on the frontal lobe cortex to remove subdural air during or after surgery. CT scanning at postoperative day 7 is helpful for determine recurrence rate.