| One versus Two Burr-hole Drainage of Chronic Subdural Hematoma and Valsalva Maneuver |
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Young-Joon Rho , Young Il Chun , Woo Jin Choe , Chang Taek Moon , Joon Cho , Young-Cho Koh , Sang Keun Chang |
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Department of Neurosurgery, Konkuk University School of Medicine, Seoul, Korea |
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| Abstract |
Objective
Chronic subdural hematomas (CSDH) are usually encountered in the elderly presenting mild to severe symptoms. A variety of surgical techniques has been used to manage the CSDH such as craniotomy, burr-hole, irrigation, closed drainage and etc. One burrhole and two burr-hole drainage are among the most common techniques. The comparison of these techniques and the effect of Valsalva maneuver after the operation were investigated.
Methods
The authors retrospectively analyzed the results of CSDH in 120 patients treated with one or two burr-hole. After the operation some patients underwent Valsalva maneuver until the removal of subdural catheter. All patients were classified by age and sex and subdivided according to the findings in the CT, clinical findings and hospital stay.
Results
Seventy nine (65.8%) patients underwent one burr-hole technique (Group A) and 41 (34.2%) patients underwent two burr-hole technique (Group B) for the evacuation of hematoma. There were no difference between two groups (X2; p>0.05). Fifty four patients (45%) with Valsalva maneuver (Group 1) after the operation were compared with 66 patients (55%) who did not do Valsalva maneuver (Group 2). We could find the difference in hematoma resolution between two groups (X2; p=0.005). Eight (6.67%) patients underwent re-drainage, demonstrated either by clinical neurological signs or on neuroradiology (X2; p>0.05).
Conclusion
The number of burr-holes in the treatment of CSDH does not affect the recurrence rate and hematoma resolution. So, single burr hole is preferred for the patients. Valsalva maneuver is worth trying after the operation as well. |
| Key Words:
Chronic subdural hematomaㆍOneㆍTwoㆍValsalva |
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