Clinical Analysis of Chronic Subdural Hematoma after Burr-Hole Craniostomy and Closed-System Drainage

ABSTRACT

In a retrospective study between January 1984, and July 1985, 50 cases of chronic subdural hematoma were analysed. All hematomas were operated on by enlarged burr-hole craniostomy and closed-system drainage. The results of the analysis were summerized as follows: 1) Eighty percent of the patients were 40 years or older. The ratio of male versus female was 4.6:1. 2) History of trauma was present in 70%, Seven patients were known to be chronic alcoholics. 3) The major clinical symptoms and signs were headache(72%), alteration of consciousness(54%), motor weakness(48%), papilledema(34%). 4) Clinical findings at admission and outcome at discharge were graded according to the scale proposed by Markwalder et al. Majority of the patients belonged to group 1(52%), followed by . group 2(40%), 3(6%). 5) The hematoma densities in brain CT at admission were hypodense(46%), isodense(34%), hyperdense(16%), and mixed-dense(4%). The shapes were planoconvex(42%), crescentic(32%), biconvex(26%). Four patients(8%) had bilateral hematomas at admission. 6) The average numbers of burr-hole craniostomy were two (80%), and the average duration of drainage was three days(72%). Only four hematomas were without neomembranes. 7) Burr-hole craniostomy and catheter drainage resulted in an excellent outcome in 43 patients(86%) at the time of discharge. There was no death in this study group.