Chronic subdural hematoma—Craniotomy versus burr hole trepanation

  title={Chronic subdural hematoma—Craniotomy versus burr hole trepanation},
  author={Yvonne Mondorf and Muaath Abu-Owaimer and Michael Robert Gaab and Joachim M. K. Oertel},
  journal={British Journal of Neurosurgery},
  pages={612 - 616}
The authors present a series of more than 200 surgical procedures for chronic subdural hematoma in a 5-year-period. Clinical presentation and neurosurgical treatment were regarded with a special focus on the surgical technique. Between March 2003 and July 2008, 193 patients (113 male and 80 female, mean age 72.5 yrs [range 26–97 yrs]) suffering from chronic subdural hematoma were retrospectively analyzed. One-hundred-fifty-one craniotomies and 42 burr holes were performed. Forty-two craniotomy… 

Single Burr Hole Craniostomy in surgical treatment of chronic subdural hematoma (Outcome and Complications)

The results of this study suggest that Single Burr Hole Craniostomy is safe, simple and effective method for surgical management of CSDH with lower recurrence rate and lower morbidity and mortality.

Chronic subdural hematoma treated by small or large craniotomy with membranectomy as the initial treatment.

Among the cases of chronic subdural hematoma initially requiring craniotomy, the large craniotomies with extended membranectomy technique reduced the reoperation rate, compared to that of the small crANIotomy with partial membran surgery technique.

Craniotomy Does Have its Share in the Management of Chronic Subdural Hematoma

In the presence of thick subdural membranes, BHD alone may not help relieve the cerebral compression and wider surgical approach in form of craniotomy and membranectomy is the answer in such situations and can be safely performed with low complications.

Single Parietal Burr-hole Craniostomy with Irrigation and Drainage for Unilateral Chronic Subdural Hematoma in Young Adults <40 Years: A Rationale behind the Procedure

SBHC with irrigation and drainage has excellent result for unilateral CSDH in young adults compared to other methods of drainage and should be considered treatment of choice unless contraindicated.

Burr-Hole Craniostomy for Chronic Subdural Hematomas by General Surgeons in Rural Kenya

Operative management of cSDH can be safely performed in rural facilities by general surgeons familiar with the procedure and with the institutional resources, and improvement of symptoms was noted in 91% of all patients.

Organized Chronic Subdural Hematomas Treated by Large Craniotomy with Extended Membranectomy as the Initial Treatment

  • M. Balevi
  • Medicine
    Asian journal of neurosurgery
  • 2017
Large craniotomy and extended membrane excision for OSDH still carry a high rate of mortality and morbidity in elderly patients.

Primary Enlarged Craniotomy in Organized Chronic Subdural Hematomas

In select cases, based on the MRI appearance, primary enlarged craniotomy seems to be the treatment of choice for achieving a complete recovery and a reduced recurrence rate in OCSH.

Radiological Features and Post-Operative Drainage Amount Independently Predict Recurrence of Chronic Subdural Hematoma after Burr-hole Craniostomy

Background: Chronic subdural hematoma (CSDH) is a common neurologic disease in elderly. It is not always a benign condition because high recurrence rate had been reported. Independent risk factors

Single Frontal Burr-hole Craniostomy Under Local Anaesthesia for Treating Chronic Subdural Haematoma in the Septuagenarians and Older Adults: Surgical Technique and Results

This surgical technique appears very effectual for CSDH, is executed at a comparatively low-cost, and, being much less disruptive than other traditional methods, may be a more homeostatic operative treatment in geriatric patients at least.

Burr-Hole Craniostomy Versus Open Craniotomy for Treatment of Combined Chronic and Subacute Subdural Haemorrhage in Patients Above 90 Years Old

In spite of the high incidence of combined acute and subacute incidence of subdural haemorrhage, burr hole craniostomy still offers better outcome for those patients with higher safe margin.



Treatment of chronic subdural hematoma by burr-hole craniostomy in adults: influence of some factors on postoperative recurrence

It is important to identify factors leading to a high or a low PR rate in the treatment of CSDHs because this may help to select appropriate surgical procedures and postoperative management to treat this condition efficiently.

Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate.

Old age, pre-existing cerebral infarction, and persistence of subdural air after surgery were significantly correlated with poor brain re-expansion (p < 0.001), which will further improve the surgical outcome for patients with CSDH.


It is not recommended that elderly patients assume an upright posture soon after burr-hole surgery to prevent postoperative atelectasis and dementia, as these might significantly increase the risk of CSDH recurrence.

[A study of acute subdural hematoma developing into hematoma with capsule formation].

It was surmised that ASDH patients with the following characteristics have a high risk of progression to CSDH during the subacute and chronic phases when conservative therapy is administered during the acute phase of the lesion.

Relations among traumatic subdural lesions.

It is suggested that the origin of CSDH is not only ASDH, but also SDG in upto a half of cases, which is produced as an epiphenomenon by separation of the dural border cell layer when the potential subdural space is sufficient.