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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(01): 96-98
DOI: 10.4103/ajns.AJNS_101_20
Original Article

Comparative study of subgaleal and subdural closed drain in surgically treated cases of chronic subdural hematoma

Jagminder Singh
Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
,
Shivender Sobti
Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
,
Ashwani Chaudhary
Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
,
Vikram Chaudhary
Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
,
Tarun Garg
Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Background: Chronic subdural hematoma (CSDH) is seen most common in geriatric patients, and trauma is the most important reason for CSDH. Operative treatment of CSDH in symptomatic patients is yet the gold standard of therapy because it allows decompression of the subdural space and aids improvement in neurological status. Burr-hole craniostomy is the most common accepted treatment for CSDH. There is still controversy regarding which type of drain placement is best in the outcome: subdural or subgaleal drain. Aim: The aim of the study was to compare the outcome of subgaleal versus subdural drain in surgically treated patients of CSDH. Materials and Methods: Patients were assigned by simple random sampling in two groups. The study was conducted from February 2016 to July 2017. A total of 70 patients were enrolled into the study and were divided in two groups (Group 1 – Subgaleal drain; Group 2 – Subdural drain). Statistical analysis was done using Chi-square and t-test. Outcome was assessed at the end of hospital stay by modified Rankin scale. Postoperative computed tomography scan was done after 24 h of surgery. Results: This study concluded that both types of drains are equally effective for the treatment of CSDH. There is a statistically significant difference in the occurrence of seizure in both the groups as there was no seizure in subgaleal drain group compared to 5 (14.3%) patients who had seizures postoperatively in subdural drain group (P = 0.020). There was insignificant difference with respect to preoperative Glasgow Coma Scale/sex/preoperative hematoma volume/postoperative hematoma volume/preoperative midline shift. Conclusion: Subgaleal drain is safe and technically easy, as subgaleal drain has no direct contact with brain parenchyma, thus less chances of brain laceration, intracerebral hematoma formation, and seizures.

Key-words:

Burr hole - chronic subdural hematoma - seizures - subdural drain - subgaleal drain

Financial support and sponsorship

Nil.




Publication History

Received: 22 March 2020

Accepted: 15 October 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kudo H, Kuwamura K, Izawa I, Sawa H, Tamaki N. Chronic subdural hematoma in elderly people: Present status on Awaji Island and epidemiological prospect. Neurol Med Chir (Tokyo) 1992;32:207-9.
  • 2 Santarius T, Lawton R, Kirkpatrick PJ, Hutchinson PJ. The management of primary chronic subdural haematoma: A questionnaire survey of practice in the United Kingdom and the Republic of Ireland. Br J Neurosurg 2008;22:529-34.
  • 3 Cenic A, Bhandari M, Reddy K. Management of chronic subdural hematoma: A national survey and literature review. Can J Neurol Sci 2005;32:501-6.
  • 4 Karibe H, Kameyama M, Kawase M, Hirano T, Kawaguchi T, Tominaga T. Epidemiology of chronic subdural hematomas. No Shinkei Geka 2011;39:1149-53.
  • 5 Krupa M. Chronic subdural hematoma: A review of the literature. Part 1. Ann Acad Med Stetin 2009;55:47-52.
  • 6 Yadav YR, Parihar V, Chourasia ID, Bajaj J, Namdev H. The role of subgaleal suction drain placement in chronic subdural hematoma evacuation. Asian J Neurosurg 2016;11:214-8.
  • 7 Edlmann E, Giorgi-Coll S, Whitfield PC, Carpenter KL, Hutchinson PJ. Pathophysiology of chronic subdural haematoma: Inflammation, angiogenesis and implications for pharmacotherapy. J Neuroinflammation 2017;14:108.
  • 8 Gazzeri R, Galarza M, Neroni M, Canova A, Refice GM, Esposito S. Continuous subgaleal suction drainage for the treatment of chronic subdural haematoma. Acta Neurochir (Wien) 2007;149:487-93.
  • 9 Zumofen D, Regli L, Levivier M, Krayenbühl N. Chronic subdural hematomas treated by burr hole trepanation and a subperiostal drainage system. Neurosurgery 2009;64:1116-21.
  • 10 Chih AN, Hieng AW, Rahman NA, Abdullah JM. Subperiosteal drainage versus subdural drainage in the management of chronic subdural hematoma (a comparative study). Malays J Med Sci 2017;24:21-30.
  • 11 Bellut D, Woernle CM, Burkhardt JK, Kockro RA, Bertalanffy H, Krayenbühl N. Subdural drainage versus subperiosteal drainage in burr-hole trepanation for symptomatic chronic subdural hematomas. World Neurosurg 2012;77:111-8.
  • 12 Guilfoyle MR, Hutchinson PJ, Santarius T. Improved long-term survival with subdural drains following evacuation of chronic subdural haematoma. Acta Neurochir (Wien) 2017;159:903-5.
  • 13 Oral S, Borklu RE, Kucuk A, Ulutabanca H, Selcuklu A. Comparison of subgaleal and subdural closed drainage system in the surgical treatment of chronic subdural hematoma. North Clin Istanb 2015;2:115-21.
  • 14 Kaliaperumal C, Khalil A, Fenton E, Okafo U, Kaar G, O'Sullivan M, et al. A prospective randomised study to compare the utility and outcomes of subdural and subperiosteal drains for the treatment of chronic subdural haematoma. Acta Neurochir (Wien) 2012;154:2083-8.