Comparison of surgical techniques for the treatment of chronic subdural hematomas: A single‑center case series

Chatzidakis,Stefanos; Bakiri,Zoe Michelle; Faropoulos,Konstantinos; Fotakopoulos,George; Georgakopoulou,Vasiliki Epameinondas; Trakas,Nikolaos; Sklapani,Pagona; Spandidos,Demetrios A.; Yiallouris,Andreas; Papadopoulos,Dimitrios

doi:10.3892/etm.2024.12618

Comparison of surgical techniques for the treatment of chronic subdural hematomas: A single‑center case series

Authors:
- Stefanos Chatzidakis
- Zoe Michelle Bakiri
- Konstantinos Faropoulos
- George Fotakopoulos
- Vasiliki Epameinondas Georgakopoulou
- Nikolaos Trakas
- Pagona Sklapani
- Demetrios A. Spandidos
- Andreas Yiallouris
- Dimitrios Papadopoulos
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Affiliations: Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, School of Medicine, Department of Medicine, European University, Cyprus, Nicosia 2404, Cyprus, Department of Neurosurgery, Nicosia General Hospital, Nicosia 2029, Cyprus, Department of Neurosurgery, General University Hospital of Larissa, Larissa 41221, Greece, Department of Pathophysiology, National and Kapodistrian University of Athens, Athens 11527, Greece, Department of Biochemistry, Sismanogleio Hospital, Athens 15126 Greece, Laboratory of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
Published online on: June 20, 2024 https://doi.org/10.3892/etm.2024.12618
Article Number: 329
Copyright: © Chatzidakis et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Chronic subdural hematoma (CSDH) is one of the most challenging realities in the neurosurgical world. The aim of the present study was to compare different surgical techniques, such as burr hole evacuation with subperiosteal drain or subdural drain and mini‑craniotomy, and to review the diverse outcomes on the post‑operative clinical state of patients. The present study was a retrospective cohort study with 122 patients with CSDH treated at a single center. The patients were separated into three groups according to the surgical technique used as follows: group 1, two burr holes with the placement of a subperiosteal drain; group 2, single burr hole per hematoma with the placement of an intradural drain; and group 3, mini‑craniotomy. The duration of hospitalization, hematoma recurrence, complications, Glasgow coma scale at discharge and mortality were reported as outcome measures. A total of 3 patients succumbed following hematoma evacuation; of these 2 patients were from group 2 and 1 patient was from group 3. The patients from groups 1 and 3 exhibited a significantly lower odds ratio (OR) of hematoma recurrence than patients in group 2 (OR, 0.76; P<0.01; and OR, 0.8; P<0.01, respectively). The patients in group 1 exhibited a significantly lower probability of having a depressed level of consciousness on discharge (OR, 0.249; P=0.031). Group 2 was associated with a statistically significant prolongation of hospitalization. On the whole, the present study demonstrates that multiple burr hole hematoma evacuation with subperiosteal drain placement and mild suction is a very promising technique with very beneficial post‑operative outcomes, such as zero mortality, a low CSDH recurrence risk, a reduced period of hospitalization and an improved post‑operative quality of life.

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