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Abstract
Objective
Chronic subdural hematoma (cSDH) is a common disorder that is readily surgically treated but has high recurrence rate. This is a preliminary report to evaluate the effectiveness of a newly designed catheter compared with the conventional one in treating cSDH.
Methods
We conducted a retrospective study of 111 patients with unilateral chronic subdural hematoma treated by burr hole craniostomy with closed-system drainage from November 2009 to September 2012. Group A was defined as patients treated with an external ventricular drainage (EVD) catheter and B as patients treated with the new catheter. We measured changes of thickness of hematoma and midline shifting in brain computed tomography (CT), amount of drainage and recurrence rate in both groups.
Results
Group A consisted of 54 and B of 57 cases. The mean duration for total removal of hematoma was 42.6±13.9 hours in group A and 30.3±11.9 hours in group B (p＜0.05). The mean amount of drainage counted per six hours cumulatively differed significantly between groups. The result (p＜0.05) showed that the newly designed catheter effectively removed the hematoma. The total recurrence rate in group A was 11% and 3.5% in group B.
References
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FIGURE 1.
The newly designed catheter with 18 holes within 5 centimeters from the tip (A), and external ventricular drainage (EVD) catheter used to treat chronic subdural hematoma conventionally (B).
FIGURE 2.
Improvement rate of maximum thickness one day (A) and one week (B) after the surgery. There is no difference between groups. ∗improvement rate: (1-value of 24 h after surgery/pre-operative value)×100.
FIGURE 3.
Improvement rate of midline shift one day (A) and one week (B) after the surgery. There is no difference between groups. ∗improvement rate: (1-value of 24 h after surgery/pre-operative value)×100.
FIGURE 4.
Mean cumulative amount of drainage in 6 hours (p< 0.05), 12 hours (p<0.05) and 24 hours (p<0.05) proportion to total amount after surgery, significantly larger in group B. ∗proportion to total vol.: cumulative vol./total vol.×100.
Table 1.
Summary of the patients characteristics between two groups
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