Subgaleal drain versus dissection of subgaleal space and closure without drain after burr-hole drainage of chronic subdural hematoma.

Surgical neurology international Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI:10.25259/SNI_363_2024
Hosam-Eldin Abd-Elazim Habib, Hossam Elnoamany, Ahmed Gabry Elnaggar
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Abstract

Background: Chronic subdural hematoma (CSDH) is a collection of blood, blood degradation products, and fluid that accumulate on the surface of the brain between its arachnoid and dural coverings. This study is to evaluate the efficacy of subgaleal drain (SGD) versus subgaleal dissection without drainage as adjuncts to burr-hole evacuation of CSDH.

Methods: A retrospective study was conducted utilizing the data of 60 patients operated for symptomatic CSDH. Patients were divided into two groups, each thirty consecutive patients: Group I, in which a SGD was inserted after CSDH evacuation through a burr-hole; and Group II, the hematoma was evacuated as in the Group I, but with no SGD insertion but instead a subgaleal pocket was created for drainage.

Results: The neurological improvement at 24 h, discharge, 2 weeks, and 6 months after surgery was comparable in both groups. The overall recurrence was 4 cases (4/60, 6.7%). The rate of recurrence and surgical infection rate were comparable in both groups. Both groups showed similar incidences of postoperative seizures, bleeding, rates of medical complications, and neurological deficits. The overall postoperative mortality was five cases (5/60, 8.3%) with no significant difference between groups.

Conclusion: Blunt dissection to open the subgaleal space and closure without a drain is a safe and efficient alternative to the insertion of a drain after the burr-hole evacuation of CSDH.

在对慢性硬膜下血肿进行钻孔引流术后,采用气囊下引流管与剥离气囊下间隙并在不使用引流管的情况下进行闭合术的对比。
背景:慢性硬膜下血肿(CSDH)是积聚在大脑表面蛛网膜和硬脑膜覆盖层之间的血液、血液降解产物和液体。本研究旨在评估在对 CSDH 进行钻孔排空术时,采用脑膜下引流术(SGD)与不采用引流术的脑膜下剥离术的辅助治疗效果:利用 60 例因症状性 CSDH 而接受手术的患者的数据进行了一项回顾性研究。患者被分为两组,每组 30 名连续患者:第一组,在通过毛细孔排空 CSDH 后插入 SGD;第二组,与第一组一样排空血肿,但不插入 SGD,而是在气门下开袋引流:两组患者术后24小时、出院、2周和6个月的神经功能改善情况相当。总复发率为 4 例(4/60,6.7%)。两组的复发率和手术感染率相当。两组术后癫痫发作、出血、内科并发症和神经功能缺损的发生率相似。术后总死亡率为 5 例(5/60,8.3%),组间无明显差异:结论:钝性剥离以打开气门下间隙并在不插入引流管的情况下进行闭合是一种安全有效的方法,可替代在 CSDH 的钻孔排空术后插入引流管。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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