Yeungnam Univ J Med.  2015 Jun;32(1):8-12. 10.12701/yujm.2015.32.1.8.

Burr hole drainage using urokinase for treatment of subacute subdural hematoma

• Kim MS
• Kim SH
• Kim OL

• KMID: 2138635
• DOI: http://doi.org/10.12701/yujm.2015.32.1.8

Abstract

BACKGROUND
Enlargement of subdural hematomas is relatively rapid in subacute stage of hematoma with clinical deterioration, which eventually necessitates surgery. The purpose of this study is to investigate the feasibility and safety of burr hole drainage using urokinase for management of patients with subacute subdural hematoma (SASDH).
METHODS
Nine patients with SASDH were treated by burr hole drainage using urokinase. Under local anesthesia a catheter was inserted into the hematoma through a burr hole. Burr hole drainage was followed by hematoma thrombolysis with instillation of urokinase (10,000 units) every 12 hours. Drainage was discontinued when a significant decrease of hematoma was observed on cranial computed tomography.
RESULTS
The patients' median age was 70 years (range, 62-87). The median Glasgow Coma Scale score before surgery was 15 (range, 11-15). Drainage was successfully performed in all patients. All patients had Glasgow Outcome Scale scores of 5 at discharge. There was no surgery-related morbidity or mortality.
CONCLUSION
A burr hole drainage using urokinase could be a safe, feasible and effective minimally invasive method with low morbidity in treatment of selected patients with SASDHs.

Keyword

Subdural hematoma; Trephination; Drainage; Urokinase

MeSH Terms

Anesthesia, Local
Catheters
Drainage*
Glasgow Coma Scale
Glasgow Outcome Scale
Hematoma
Hematoma, Subdural*
Humans
Mortality
Trephining
Urokinase-Type Plasminogen Activator*
Urokinase-Type Plasminogen Activator