Comparison of Two Drainage Systems on Chronic Subdural Hematoma Recurrence.
| Autor: | Takroni R; Division of Neurosurgery, Department of Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada.; King Faisal Medical City for Southern Regions, Abha, Saudi Arabia., Zagzoog N; Division of Neurosurgery, Department of Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada., Patel N; Department of Health, Evidence and Impact, McMaster University, Ontario, Canada., Martyniuk A; Division of Neurosurgery, Department of Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada., Singh S; Division of Neurosurgery, Department of Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada., Farrokhyar F; Department of Health, Evidence and Impact, McMaster University, Ontario, Canada., Trivedi A; Michael G. DeGroote School of Medicine, McMaster University, Ontario, Canada., Alotaibi M; Division of Neurosurgery, Department of Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada., Algird A; Division of Neurosurgery, Department of Surgery, Hamilton General Hospital, Hamilton, Ontario, Canada. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of neurological surgery. Part A, Central European neurosurgery [J Neurol Surg A Cent Eur Neurosurg] 2023 Mar; Vol. 84 (2), pp. 157-166. Date of Electronic Publication: 2021 Nov 16. |
| DOI: | 10.1055/a-1698-6212 |
| Abstrakt: | Background: Chronic subdural hematoma (CSDH) is a common type of intracranial hemorrhage, especially among the elderly, with a recurrence rate as high as 33%. Little is known about the best type of drainage system and its relationship with recurrence. In this study, we compare the use of two drainage systems on the recurrence rate of CSDH. Methods: We retrospectively analyzed the charts of 172 CSDH patients treated with bedside twist drill craniostomy (TDC) and subdural drain insertion. Patients were divided into two groups: group A ( n = 123) received a pediatric size nasogastric tube [NGT]), whereas group B ( n = 49) had a drain commonly used for external ventricular drainage (EVD). Various demographic and radiologic data were collected. Our main outcome was recurrence, defined as symptomatic re-accumulation of hematoma on the previously operated side within 3 months. Results: In all, 212 cases of CSDH were treated in 172 patients. The majority of patients were male (78%) and had a history of previous head trauma (73%). Seventeen cases had recurrence, 11 in group A and 6 in group B. The use of antiplatelet and anticoagulation agents was associated with recurrence ( p = 0.038 and 0.05, respectively). There was no difference between both groups in terms of recurrence (odds ratio [OR] = 1.42; 95% confidence interval [CI]: 0.49-4.08; p = 0.573). Conclusion: CSDH is a common disease with a high rate of recurrence. Although using a drain postoperatively has shown to reduce the incidence of recurrence, little is known about the best type of drain to use. Our analysis showed no difference in the recurrence rate between using the pediatric size NGT and the EVD catheter post-TDC. Competing Interests: None declared. (Thieme. All rights reserved.) |
| Databáze: | MEDLINE |
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