A Novel Technique for Eliminating Pneumocephalus in Chronic Subdural Hematoma Burr-hole Surgery

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-07-18 DOI:10.1016/j.neuchi.2025.101703

Jiankuai Zhou, Huimin Shen, Jianchen Jin, Guotao Peng, Dan Xu, Yili Chen, Jun Mo

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引用次数: 0

Abstract

Background

Chronic subdural hematoma (cSDH) is a common neurosurgical condition with increasing prevalence in the aged population. Burr-hole surgery is the most common and effective treatment. However, subsequent pneumocephalus is a complication and has been a cause leading to recurrence and reoperation. This study aims to describe a novel technique to eliminate pneumocephalus via subdural catheter following subdural hematoma evacuation, as a method to reduce subdural potential space and decrease recurrence.

Methods

In this retrospective study, 52 patients who underwent burr-hole craniotomy evacuation of cSDH between January 2023 and September 2024 were assessed. Ten patients underwent modified intraoperative pneumocephalus elimination. Quantitative volumetric analysis was performed on preoperative, postoperative, and one-month follow-up computed tomography scans to assess the volume of pneumocephalus.

Results

There were no differences in baseline characteristics between the present technique and control groups. The present technique resulted in decreased pneumocephalus volume (5.6 mL vs 16.6 mL; P = .035) and subdural air ratio (0.05 vs 0.19; P = .010) on post-operative day 1. At three-month follow-up, the recurrence rate was lower in the present technique group, though this difference did not reach statistical significance (0.0% vs 4.7%; P = 1.000).

Conclusion

In conclusion, we present an innovative surgical technique that demonstrates remarkable efficacy in eliminating subdural air during cSDH burr-hole surgery. This technique offers a safe, streamlined approach that not only simplifies the surgical procedure but also shows promise in reducing cSDH recurrence rates.

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一种消除慢性硬膜下血肿颅内气肿的新技术

背景：慢性硬膜下血肿（cSDH）是一种常见的神经外科疾病，在老年人群中发病率越来越高。钻孔手术是最常见、最有效的治疗方法。然而，继发的脑气是一种并发症，是导致复发和再次手术的原因。本研究旨在描述一种在硬膜下血肿引流后通过硬膜下导管消除脑气的新技术，以减少硬膜下电位空间和减少复发。方法回顾性分析2023年1月至2024年9月间，52例经钻孔开颅引流的cSDH患者。10例患者行改良术中气头消除术。对术前、术后和随访1个月的计算机断层扫描进行定量体积分析，以评估脑积水的体积。结果本技术与对照组在基线特征上无差异。目前的技术导致气头体积减少(5.6 mL vs 16.6 mL；P = 0.035)和硬膜下空气比(0.05 vs 0.19；P = 0.010)。随访3个月时，该技术组复发率较低，但差异无统计学意义(0.0% vs 4.7%；P = 1.000)。总之，我们提出了一种创新的手术技术，在cSDH钻孔手术中消除硬膜下空气效果显著。这项技术提供了一种安全、简化的方法，不仅简化了手术过程，而且在降低cSDH复发率方面也显示出希望。

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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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.