Open Drainage in Chronic Subdural Hematomas: A Prospective Study of 189 Cases

Background & Importance: Chronic subdural hematoma (CSH) is one of the most frequent intracranial hemorrhages in adults. However,gold standard treatment of CSH is not yet defined. Since the 80’s, closed drainage is a standard among techniques using drains because theopen type has been incriminated in high rates of postoperative infections. However, closed drainage requires materiel which is sometimesnot available or expensive in some countries. Open drainage was reintroduced in our department in the middle of the 90’s because ofeconomic crisis at this time. We have then conducted a prospective study to assess safety and efficacy of open drainage in treatment ofCSH.Case Presentation: A prospective study of adult patients with CSH was conducted from January 2008 to December 2011. All patients havethe same surgical procedure which included one burr-hole craniostomy, spontaneous evacuation and open drainage. The study focused oninfectious complications, postoperative seizures, and recurrences. Results are compared with those of literature.In our study, 189 patients were operated with mean age of 69.2 years old. Of all, 163 patients were cured. Overall rate of complicationswas 15.34% with an infection rate of 1.58%, a postoperative seizure rate of 1.05% and a recurrence rate of 14.2%. Mortality rate was 5.8%.Results were in concordance with those of large series of literature.Conclusion: Data of the current study suggested that open drainage is a safe and efficient method in treatment of CSH. It is also a costefficienttreatment that could be very interesting for middle- a nd low-income countries.

Keywords:

Chronic Subdural Hematoma , Open Drainage , Infection , Sur gical Technique