Chronic subdural hematoma surgery
Chronic subdural hematoma (CSDH) evacuation is one of the most frequent surgical procedures in neurosurgery 1)
Chronic subdural hematoma surgical techniques
Routine postoperative CT
Routine post-operative CT brain for burr hole drainage of CSDH may be unnecessary in view of the good predictive value of pre-operative volume, and also because it is not predictive of the clinical outcome 2).
Scheduled postoperative cranial imaging with indwelling drains was not shown to be beneficial and misses information of intracranial damage inflicted by removal of drains. Brokinkel et al recommend CT-scanning after drainage removal 3).
Complications
1)
S.A. Almenawer, F. Farrokhyar, C. Hong, W. Alhazzani, B. Manoranjan,
B. Yarascavitch, P. Arjmand, B. Baronia, K. Reddy, N. Murty, S. Singh, Chronic
subdural hematoma management: a systematic review and meta-analysis of 34,829
patients, Ann. Surg. 259 (2014) 449–457, https://doi.org/10.1097/SLA.
0000000000000255.
2)
Ng HY, Ng WH, King NK. Value of routine early post-operative computed tomography in determining short-term functional outcome after drainage of chronic subdural hematoma: An evaluation of residual volume. Surg Neurol Int. 2014 Sep 19;5:136. doi: 10.4103/2152-7806.141299. eCollection 2014. PubMed PMID: 25298918.
3)
Brokinkel B, Ewelt C, Holling M, Hesselmann V, Heindel WL, Stummer W, Fischer
BR. Routine postoperative CT-scans after burr hole trepanation for chronic
subdural hematoma - better before or after drainage removal? Turk Neurosurg.
2013;23(4):458-63. doi: 10.5137/1019-5149.JTN.7269-12.0. PubMed PMID: 24101264.