J Korean Neurotraumatol Soc.  2007 Jun;3(1):25-28. 10.13004/jknts.2007.3.1.25.

The Saline Irrigation Effect Using Closed System Drainage on Chronic Subdural Hematoma

• Jang JW
• Kim TW
• Park KH
• Kim JO
• Kim JC
• Chi MP

• KMID: 2162856
• DOI: http://doi.org/10.13004/jknts.2007.3.1.25

Abstract

OBJECTIVE
Though the treatment using burr hole trephination in chronic subdural hematoma (CSDH) is simple and effective, but recurrence is not a few and the appropriate method of drainage is still controversial. We retospectively reviewed recurrence of CSDH, complete resolution rate and occurrence of postoperative complication between two groups: closed drainage group after saline irrigation and closed drainage group without saline irrigation.
METHODS
Between January 2004 and June 2006, fifty five patients who had taken operation using burr-hole in unilateral CSDH were divided into two groups. Twenty eight patients (group A) were drained hematoma after saline irrgation and twenty seven patients (group B) were inserted catheter after dural incision immediately without saline irrigation. All catheter were placed frontal area and the catheter was removed postoperative second day.
RESULTS
There were 4 recurrence of hematoma (14.3%), 8 postoperative pneumocephalus (28.6%) in group A and 3 recurrence (11.1%) and 6 pneumocephalus (22.2%) in group B. The total resolution of hematoma rate was 45.8% in group A and 58.3% in group B within postoperative seven days. All patients were resolved totally until postoperative one month except one patient in group A. Postoperative complication including postoperative seizure, infection and tension pneumocephalus was not occured in all patients.
CONCLUSION
The saline irrigation is not decreased the recurrence rate and resolution rate compare to non-irrigation group. So, saline irrigation is not needed in CSDH operation using burr-hole and closed-system drainage.

Keyword

Subdural hematoma; Saline irrigation; Recurrence; Resolution

MeSH Terms

Catheters
Drainage*
Hematoma
Hematoma, Subdural
Hematoma, Subdural, Chronic*
Humans
Pneumocephalus
Postoperative Complications
Recurrence
Seizures
Trephining