Published: 2021-09-28

Mini craniotomy for chronic subdural haematoma: surgical outcome from a single institution experience and predictors of success

Mohammad Nazrul Hossain, Mohammad Humayun Rashid, Israt Zerin Eva, M. Sharif Bhuiyan, Abdullah Al Mamun


Background: Chronic subdural hematoma (CSDH) is an increasingly common neurological disease in daily neurosurgical practice. Despite the wide prevalence of CSDH, there remains a lack of consensus regarding numerous aspects of its surgical management. The diagnosis and treatment are well established but there are different surgical procedures and outcome related to these procedures are not completely understood.

Methods: The study conducted was conducted in department of neurosurgery at Ibrahim cardiac hospital and research institute, Dhaka, Bangladesh between January 2019 to July 2020, 105 patients were treated for chronic subdural haematoma This study evaluated the clinical features, radiological findings and surgical outcome by mini craniotomy assessed by modified Rankin scale (mRS) score and Glasgow outcome scale (GOS) score in a large series of patients treated at single institution.

Results: At 6 months follow up, only one patient died (0.95%) because of co-morbidities and not directly related to the chronic subdural haematoma, 15 patients (14.3%) improved to mRS 0, 33.33% showed only mild symptoms without any significant disability-mRS 1, slight disability was observed in 28.5% patients, moderate disability was observed in 17.14% patients-mRS 3, moderately severe disability was observed in 5.7%-mRS 4.

Conclusions: GOS score at 6 months follow up which shows majority of the patient improved to GOS score 4 (45.71%) and 5 (38.09%). Based on these results, among various method of surgical management, mini craniotomy provides better outcome.


CSDH, Surgical outcome by mini craniotomy, Outcome

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Santarius T. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet. 2009;374:1067-73.

Chon KH, Lee JM, Koh EJ, Choi HY. Independent predictors for recurrence of chronic subdural haematoma. Actaneurochirurgica. 2012;154(9):1541-8.

Cousseau DH, Echevarria Martin G, Gaspari M, Gonorazky SE. Chronic and subacute subdural haematoma. An epidemiological study in a captive population. Rev Neurol. 2001;32:821-4.

Ducruet AF. The surgical management of chronic subdural hematoma. Neurosurg Rev. 2012;35:155-69.

Gelabert-Gonzalez M, Iglesias-Pais M, Garcia-Allut A, Martinez-Rumbo R. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin neurol neurosurgery. 2005;107(3):223-9.

Hammer A, Tregubow A, Kerry G, Schrey M, Hammer C, Steiner HH. Predictors for Recurrence of Chronic Subdural Haematoma. Turk Neurosurg. 2016;17347-16.

Lee JM, Park JC, Kim JH. Retrospective analysis of risk factors for recurrent chronic subdural haematoma. Nerve. 2016;2(2):54-8.

Lindvall P, Koskinen LOD. Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas. J clin neurosci. 2009;16(10):1287-90.

Okada Y, Akai T, Okamoto K. A comparative study of the treatment of chronic subdural hematoma-burr hole drainage versus burr hole irrigation. Surg Neurol. 2002;57:405-9.

Pedersen CB, Sundbye F, Poulsen FR. No Value of Routine Brain Computed Tomography 6 Weeks after Evacuation of Chronic Subdural Haematoma. Surgery J. 2017;3(4):e174.

Santarius T, Kirkpatrick PJ, Kolias AG, Hutchinson PJ. Working toward rational and evidence-based treatment of chronic subdural hematoma. Clin Neurosurg. 2010;57:112-22.

Stanisic M. Local and systemic pro-inflammatory and anti-inflammatory cytokine patterns in patients with chronic subdural hematoma: a prospective study. Inflamm Res. 2012;61:845-52.

Tugcu B, Tanriverdi O, Baydin S, Gunaldi O, Ofluoglu E, Demirgil BT. Can Recurrent Chronic Subdural Haematomas Be Predicted? Retrospective Analysis Of 136 Cases. Dusunen Adam. 2010;23(1):44.

Yvonne M, Muttah AO, Michael RG, Joachim MKO. Chronic subdural hematoma-Craniotomy versus burr hole trepanation. Bri J Neurosurg. 2009;23(6):612-6.