| Outcome of Minicraniotomy for Chronic Subdural Hematoma: Technique (Procedure of Minicraniotomy) & it's Advantages |
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Jin-Ho Seo , Chul-Ku Jung , Chul-Young Lee , Hyun Woo Kim , Ho-Gyun Ha |
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Department of Neurosurgery, Konyang University College of Medicine, Daejeon, Korea |
| 만성 경막하 혈종에 대한 Minicraniotomy의 결과: 수술 술기 및 이점 |
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건양대학교 의과대학 신경외과교실 |
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서진호ㆍ정철구ㆍ이철영ㆍ김현우ㆍ하호균 |
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| Abstract |
Objective
Several surgicial techinques are described for the management of chronic subdural hematomas, such as one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation and small craniotomy with irrigation and closed system drainage.
Methods
and Materials: The study was a retrograde analysis of 177 cases of surgically managed chronic subdural hematomas from January 1st 2007 to March 31th 2011. In 152 cases before May 2010, simple burr-hole craniostomy was performed by 7 surgeons including the author and 25 cases after that was managed by minicraniotomies. A 2×2 cm sized minicraniotomy was made underneath the temporal muscle, cruciate dural incision was done and outer membrane of chronic subdural hematoma was removed. And then, the hematoma was removed after irrigation with an external ventricular drainage catheter and the tip positioned directed frontally.
Results
Recurrence for the burr-hole craniostomy managed group were 11 cases (7.2% of 152 cases). But there were 1 case (4%) recurrence for the 25 cases managed by a minicraniotomy. The advantages for minicraniotmy is that in cases of thin hematomas, the cather can be situated in an obtuse angle avoiding cortical injury. The irrigation can be performed multidirectionally. And direct adhesion of the dura mater to the temporal muscle can be avoided so avoiding the sunken down appearance of the overlying scalp. It can be also speculated that the temporalmuscle can help in the absorption process of the hematoma.
Conclusion
In the author's opinion, minicraniotomy for the management of chronic subdural hematomas has various advantages compared to the previous methods including the esthetic aspect as well as the recurrence rate. |
| Key Words:
Chronic subdural hematomaㆍMinicraniotomyㆍRecurrence |
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