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Role of "Single Burr-Hole and Saline Lavage" in Chronic Subdural Hematoma (CSDH): The Need of another Clinical Prospective Epidemiological Study

Background: Chronic subdural hematoma (CSDH) is a neurosurgical entity which mimics many neuropsychiatric conditions. "Single burr-hole with saline lavage" technique is an adequate and safe treatment for this entity; putting two holes in this pathology mayn't always be necessary. Aim: The aim of this study is to find out the spectrum of incidence, risk factors and varieties of presentations of CSDH and its management with "single burr hole and saline lavage", along with the complications.

Methods and findings: The prospective study was conducted on all the patients having clinical and radiological evidence of CSDH admitted to the department of neurosurgery, Veer Surendra Sai Medical College (VSSMC), Burla, Odisha, India during the period October 2010 to October 2012. All the patients were enrolled in the proforma listed below. Post operatively patients were followed up from 3 months to 4 1/2 years. 52.8% of the patients are between 55-74 years. CSDH is due to trauma or trivial trauma in 83.3%. Aspirin was responsible as a risk factor in 19.4% cases. 25% patients are found to abuse alcohol. Impaired consciousness was noted in 86.1% cases, seizures in 11.1%, hemiparesis in 8.3%, features of raised intra cranial pressure i.e. headache in 33.3% and pupillary abnormality in 25% of cases (p<0.05).

Conclusion: "Single burr-hole and saline lavage" technique is an adequate and safe treatment; having the lowest recurrence and mortality. A short operating time, ease and simplicity of the procedure also support the technique over other procedures like double burr hole drainage. This study in the South Asian nation also provides with the epidemiological data of this important neurosurgical entity.


Soubhagya Ranjan Tripathy, Sanjib Mishra, Anup kumar Mahapatra, Rabi Narayan Panda,
Harekrishna Majhi and Jagmohan Mishra

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