Effect of Saline Irrigation in the Surgical Treatment of Chronic Subdural Hematoma

Han Yu Seong; Jun Bum Park; Soon Chan Kwon; Hong Bo Sim; Young Kim; In Uk Lyo

doi:10.13004/jknts.2008.4.1.19

Journal List > J Korean Neurotraumatol Soc > v.4(1) > 1084021

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Seong, Park, Kwon, Sim, Kim, and Lyo: Effect of Saline Irrigation in the Surgical Treatment of Chronic Subdural Hematoma

Clinical Article

Journal of Korean Neurotraumatology Society 2008; 4(1): 19-23.

Published online: 30 June 2008

DOI: https://doi.org/10.13004/jknts.2008.4.1.19

Effect of Saline Irrigation in the Surgical Treatment of Chronic Subdural Hematoma

Han Yu Seong, MD, Jun Bum Park, MD, Soon Chan Kwon, MD, Hong Bo Sim, MD, Young Kim, MD, In Uk Lyo, MD

Department of Neurosurgery, University of Ulsan College of Medicine, Ulsan, Korea.

Address for correspondence: In Uk Lyo, MD. Department of Neurosurgery, University of Ulsan College of Medicine, 290-3 Jeonha-dong, Dong-gu, Ulsan 682-714, Korea. Tel: +82-52-250-7139, Fax: +82-52-250-7138, iulyo1@uuh.ulsan.kr

Abstract

Objective

A number of different techniques are used to treat chronic subdural hematomas (CSDH) surgically. We analyzed whether it is necessary to perform the irrigation after the burr-hole craniostomy in treating CSDH.

Methods

In this study, 40 CSDH were surgically treated and analyzed retrospectively. Results of the cases that underwent irrigation (group A; N=26) were compared with those did not underwent irrigation (group B; N=14). We used Markwalder grading system to classify clinical status.

Results

There was no statistical difference in the Markwalder grade between two groups at 3 months after surgery. Hematoma thickness on computed tomography was decreased in group A compared to group B at 1 week postoperatively and was slightly more decreased in group B at 1 month later. Recurrence rates were 8% in group A and 0% in group B but there was no statistical difference.

Conclusion

We believe that the burr-hole craniostomy-closed system drainage and non-irrigation technique is also reliable and effective method compared to irrigation technique in the treatment of CSDH and may reduce complication related to irrigation.

Keywords: Chronic subdural hematoma, Closed system drainage, Irrigation

Figures and Tables

FIGURE 1

The comparison of recurrece rate after surgery for chronic subdural hematoma between two groups.

FIGURE 2

The comparison of post-operative clinical Grades between two groups with Markwalder grade.

FIGURE 3

Remaining hematoma thickness at 1 week after operation.

FIGURE 4

Remaining hematoma thickness at 4 weeks after operation.

TABLE 1

Markwalder grading system

TABLE 2

Underlying disease in 40 patients with chronic subdural hematoma

HTN: hypertension, DM: diabetes mellitus, ESRD: end-stage renal disease

TABLE 3

The comparison of expected factors influencing the results between the two groups

^*p-value less than 0.05 was considered statistically significant, ^†mean days between the onset of symptom and operation for chronic SDH. N: numbers, M: male, F: female, Sx: symptom, SDH: subdural hematoma, HFU: hounsfield unit, CT: computer tomography, Fr: frontal, P: parietal, T: temporal

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