Frontal placement of subdural drain for subdural hemorrhage: A single center experience

Placing a drain following evacuation of Chronic Subdural Hemorrhage (CSDH) has beneficial outcome for patients. The placement of the drain’s tip however is debatable as it has different rationale among neurosurgeons. Objective: The objective is to see whether the outcome is satisfactory by putting the tip of the drain at the frontal region of the sub dural space. Methodology: We retrospectively studied all patients who had CSDH underwent surgery in our center between January 2013 to December 2016. A total of 34 patients with CSDH underwent drilling of one burr hole and irrigation of CSDH. Silicone catheter placed in the sub dural space and the tip of the drain in the frontal region. We measured the SDH volume reduction and volume of pneumocranium post operatively as our outcomes of the study. Results: The mean reduction of SDH volume after surgery is 8.11 cc (73%), while the mean volume of pneumocranium post SDH drainage is 1.58 cc with a range of 0 cc to 9 cc. The mean Global Outcome Score is 2.85 and the recurrence, which need re-operation are 2 cases (6%). Conclusion: The retrospective case series shows a good potential outcome based on the reduction of SDH volume after surgery. A proper randomized trial is needed to determine the efficacy of the frontal placement of the subdural catheter for a comparable outcome.