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Comparative clinical outcomes of irrigation techniques in burr-hole craniostomy for chronic subdural hemorrhage: a multicenter cohort study

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Abstract

Background

Chronic Subdural Hemorrhage(cSDH) is often treated with surgical blood drainage, but concerns about recurrence and outcomes persist. Surgical techniques, including irrigation, vary. This study compares the outcomes of irrigation in cSDH surgery.

Materials and methods

From September 2020 to September 2022, 92 cSDH patients underwent surgery. Two different irrigation methods were used: extensive irrigation (IG) and non-irrigation (NIG). Method of irrigation was selected by each surgeon’s preference. Parameters measured included volume of hematoma changes, midline shifting, complications, and basic demographics. Recurrence was defined as symptomatic or hematoma expansion more than double the volume before surgery. Factors predicting recurrence and irrigation method impact were analyzed.

Results

Eleven patients were excluded because of bilateral or related to other disease. We analyzed 81 patients (44 NIG, 37 IG). Recurrence occurred in 6 IG cases (16.2%) and 1 NIG case (2.3%). Irrigation method significantly affected recurrence (P = 0.043). Age, gender, medication, medical history, and preoperative measurements had no major impact on recurrence. NIG had unexpected cases of intracerebral hemorrhage.

Conclusion

Extensive irrigation may increase recurrence in cSDH drainage. Non-irrigation drainage had fewer recurrences, but unexpected complications arose. Careful drainage in non-irrigated cases is crucial.

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Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

We used ChatGPT ((https://chat.openai.com/) to correct English grammars but no new ideas nor sentences are generated by artificial intelligence large language model.

We used openstat (https://openstat.ai/, Zarathu Co, Seoul, Korea) which is web based statistical analyzing program based on R version 4.3.3(R Foundation for Statistical Computing, Vienna, Austria).

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Authors and Affiliations

  1. Department of Neurosurgery, Konkuk University Medical Center, Neungdong-Ro, Gwang**-Gu, Seoul, Republic of Korea

    Ho Seong Cho, Hyun-Seok Lee, Yoo Sung Jeon & Kyung Rae Cho

  2. Department of Neurosurgery, Busan Paik Hospital, Inje University, School of Medicine, Busan, Korea

    Won Hee Lee

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Contributions

HSC: Conceptualization; Data curation; Formal analysis; Writing original draft, HSL: Data curation; Statistical analysis, YSJ: Data curation; Editing original draft, WHL: Data curation; Editing original draft; Supervision; Validation, KRC: Conceptualization; Investigation; Methodology; Project administration; Resources; Software; Supervision; Validation; Visualization; Data curation; Formal analysis; Writing and editing original draft;

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Correspondence to Kyung Rae Cho.

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During the preparation of this work the authors used ChatGPT, an AI language model developed by OpenAI in order to enhance the article's readability by ensuring grammatical correctness and providing readers with the intended information. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

Competing interests

The authors declare no competing interests.

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Cho, H.S., Lee, HS., Jeon, Y.S. et al. Comparative clinical outcomes of irrigation techniques in burr-hole craniostomy for chronic subdural hemorrhage: a multicenter cohort study. Eur J Trauma Emerg Surg (2024). https://doi.org/10.1007/s00068-024-02586-9

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  • DOI: https://doi.org/10.1007/s00068-024-02586-9

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