Comparative analysis of the results of surgical treatment of chronic subdural hematomas by craniotomy and burr hole surgery

Abstract

A chronic subdural hematoma is a disease of the elderly. The analysis of a series of more than 200 surgical interventions for chronic subdural hematoma over a 5‑year period is presented. The clinical picture and neurosurgical treatment are considered with a special emphasis on the surgical technique. Material and methods. In the period from 2017 to 2022, a retrospective analysis of 120 patients (74 men and 46 women, with a mean age of 77.4 years [ranging from 24 to 89 years]) suffering from chronic subdural hematoma was performed. Results. 88 craniotomies and 32 burr holes were performed. Forty-two patients after craniotomy (28 %) required surgical revision, in contrast to 6 patients after burr hole surgery (14 %). Craniectomy was performed as a last resort after at least 3 previous evacuations. Conclusion. Craniotomy seems to have a higher chronic subdural hematoma recurrence rate; therefore, burr hole surgery should be a preferable technique. Craniectomy may be a good therapy option for complicated recurrent chronic subdural hematomas.