Comparison of the Burr Hole Craniostomy Techniques for the Treatment of Chronic Subdural Hematoma

Main Article Content

Murat Atar
Gökhan Gürkan


Objective: To compare three different surgical techniques for chronic subdural hematoma (CSDH), one of the most common neurosurgical diseases increasingly affecting the elderly, and for which there is no standard treatment currently.

Material and Methods: We included 28 patients diagnosed with CSDH and retrospectively analysed their data. The surgical techniques were compared to subgroups of the burr-hole craniostomy technique.

Results: The mean age of included patients was 72.71 ± 10.81 years, and the male/female ratio was 2/5. Preoperative subdural hematoma volume was 113.63 ± 40.74 cc, and the Hounsfield unit value was 33.66 ± 8.67 HU. The mean operative time was 60.89 ± 20.04 min, and the mean hospital stay was 6.17 ± 2.56 days. Detectable radiologic complete recovery was 42.69 ± 17.46 days.

Conclusion: All surgery subgroups experienced successful outcomes during long-term follow-up. The irrigation technique demonstrated no superiority to the other two techniques and the complication rate was significantly lower with the endoscopic technique


Download data is not yet available.

Article Details

How to Cite
Atar, M., & Gürkan, G. (2023). Comparison of the Burr Hole Craniostomy Techniques for the Treatment of Chronic Subdural Hematoma . Medical Science and Discovery, 10(4), 264–269.
Research Article
Received 2023-04-12
Accepted 2023-04-24
Published 2023-04-27


Mehta V, Harward SC, Sankey EW, Nayar G, Codd PJ. Evidence based diagnosis and management of chronic subdural hematoma: A review of the literature. J Clin Neurosci. 2018 Apr;50:7-15. doi: 10.1016/j.jocn.2018.01.050. Epub 2018 Feb 7.

Feghali J, Yang W, Huang J. Updates in Chronic Subdural Hematoma: Epidemiology, Etiology, Pathogenesis, Treatment, and Outcome. World Neurosurg. 2020 Sep;141:339-345. doi: 10.1016/j.wneu.2020.06.140. Epub 2020 Jun 25.

Link TW, Rapoport BI, Paine SM, Kamel H, Knopman J. Middle meningeal artery embolization for chronic subdural hematoma: Endovascular technique and radiographic findings. Interv Neuroradiol. 2018 Aug;24(4):455-462. doi: 10.1177/1591019918769336. Epub 2018 May 2.

Gelabert-Gonz a lez M , Iglesias-Pais M , Garc i a-Allut A ,Mart inez-Rumbo R . Chronic subdural haematoma: surgical treatment and outcome in 1000 cases . Clin Neurol Neurosurg 2005 ; 107 : 223 – 9 .

Mori K , Maeda M . Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate . Neurol Med Chir (Tokyo) 2001 ; 41 : 371 – 81 .

Santarius T, Kirkpatrick PJ, Ganesan D, Chia HL, Jalloh I, Smielewski P. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet (London, England) 2009;374:1067–73.

Almenawer SA, Farrokhyar F, Hong C, Alhazzani W, Manoranjan B, Yarascavitch B, et al. Chronic subdural hematoma management: a systematic review and meta-analysis of 34,829 patients. Ann Surg 2014;259:449–57.

Belkhair S, Pickett G. One versus double burr holes for treating chronic subdural hematoma meta-analysis. Can J Neurol Sci 2013;40:56–60.

Liu W, Bakker NA, Groen RJ. Chronic subdural hematoma: a systematic review and meta-analysis of surgical procedures. J Neurosurg. 2014 Sep;121(3):665-73. doi: 10.3171/2014.5.JNS132715. Epub 2014 Jul 4. PMID: 24995782.

Xu C, Chen S, Yuan L, Jing Y. Burr-hole Irrigation with Closed-system Drainage for the Treatment of Chronic Subdural Hematoma: A Meta-analysis. Neurol Med Chir (Tokyo). 2016;56(2):62-8. doi: 10.2176/nmc.ra.2015-0013. Epub 2015 Sep 17. PMID: 26377830; PMCID: PMC4756245.

Uda H, Nagm A, Ichinose T, Onishi Y, Yoshimura M, Tsuruno T, Ohata K. Burr hole drainage without irrigation for chronic subdural hematoma. Surg Neurol Int. 2020 May 2;11:89. doi: 10.25259/SNI_550_2019. PMID: 32494371; PMCID: PMC7265465.

Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, DeRosa PL, Andersen KN, Sussman E, Carpenter A, Connolly ES Jr. The surgical management of chronic subdural hematoma. Neurosurg Rev. 2012 Apr;35(2):155-69; discussion 169. doi: 10.1007/s10143-011-0349-y. Epub 2011 Sep 10. Erratum in: Neurosurg Rev. 2015 Oct;38(4):771.

Lega BC, Danish SF, Malhotra NR, Sonnad SS, Stein SC. Choosing the best operation for chronic subdural hematoma: a decision analysis. J Neurosurg. 2010 Sep;113(3):615-21. doi: 10.3171/2009.9.JNS08825. PMID: 19877806.

Most read articles by the same author(s)