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Objective : Chronic subdural hematoma (CSDH) is one of the most common types of traumatic intracranial hemorrhage, usually occurring in the
older patients, with a good surgical prognosis. Burr hole craniostomy is the most frequently used neurosurgical treatment of CSDH. However,
there have been only few studies to assess the role of the number of burr holes in respect to recurrence rates. The aim of this study is to compare
the postoperative recurrence rates between one and two burr craniostomy with closed-system drainage for CSDH.
Methods : From January 2002 to December 2006, 180 consecutive patients who were treated with burr hole craniostomy with closed-system
drainage for the symptomatic CSDH were enrolled. Pre- and post-operative computed tomography (CT) scans and/or magnetic resonance imaging
(MRI) were used for radiological evaluation. The number of burr hole was decided by neurosurgeon’s preference and was usually made on the
maximum width of hematoma. The patients were followed with clinical symptoms or signs and CT scans. All the drainage catheters were
maintained below the head level and removed after CT scans showing satisfactory evacuation. All patients were followed-up for at least 1 month
after discharge.
Results : Out of 180 patients, 51 patients were treated with one burr hole, whereas 129 were treated with two burr holes. The overall
postoperative recurrence rate was 5.6% (n = 10/180) in our study. One of 51 patients (2.0%) operated on with one burr hole recurred, whereas 9
of 129 patients (7.0%) evacuated by two burr holes recurred. Although the number of burr hole in this study is not statistically associated with
postoperative recurrence rate (p > 0.05), CSDH treated with two burr holes showed somewhat higher recurrence rates.
Conclusion : In agreement with previous studies, burr hole craniostomy with closed drainage achieved a good surgical prognosis as a treatment
of CSDH in this study. Results of our study indicate that burr hole craniostomy with one burr hole would be sufficient to evacuate CSDH with
lower recurrence rate.권호기사
참고문헌 (25건) : 자료제공( 네이버학술정보 )
| 번호 | 참고문헌 | 국회도서관 소장유무 |
|---|---|---|
| 1 | THE ROLE OF POSTOPERATIVE PATIENT POSTURE IN THE RECURRENCE OF TRAUMATIC CHRONIC SUBDURAL HEMATOMA AFTER BURR-HOLE SURGERY  |
미소장 |
| 2 | Outcomes and recurrence rates in chronic subdural haematoma. |
미소장 |
| 3 | Cousseau DH, Echevarria MG, Gaspari M, Gonorazky SE : [Chronic and subacute subdural hematoma. An epidemiological study in a captive population.] Rev Neurol 32 : 821-824, 2001 | 미소장 |
| 4 | Ernestus RI, Beldzinski P, Lanfermann H, Klug N : Chronic subdural hematoma : surgical treatment and outcome in 104 patients. Surg Neurol 48 : 220-225, 1997 | 미소장 |
| 5 | Retrospective Analysis of Re-operated Patients after Chronic Subdural Hematoma Surgery | 소장 |
| 6 | A Clinical Analysis of Chronic Subdural Hematoma according to Age Factor | 소장 |
| 7 | Factors Influencing RecurrentChronic Subdural Hematoma after Surgery | 소장 |
| 8 | Treatment of chronic subdural haematoma with burr-hole craniostomy and closed drainage. |
미소장 |
| 9 | Bilateral chronic subdural hematoma cases showing rapid and progressive aggravation |
미소장 |
| 10 | Strict closed-system drainage for treating chronic subdural haematoma. |
미소장 |
| 11 | Factors Affecting Brain Re-expansion after Simple Burr Hole Drainage in Chronic Subdural Hematoma | 소장 |
| 12 | Reduction in the number of repeated operations for the treatment of subacute and chronic subdural hematomas by placement of subdural drains. |
미소장 |
| 13 | The course of chronic subdural hematomas after burr-hole craniostomy and closed-system drainage. |
미소장 |
| 14 | Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma after burr-hole irrigation and closed-system drainage. |
미소장 |
| 15 | Clinical Factors of Recurrent Chronic Subdural Hematoma |
미소장 |
| 16 | Robinson RG : Chronic subdural hematoma: surgical management in 133 patients. J Neurosurg 61 : 263-268, 1984 | 미소장 |
| 17 | Rohde V, Graf G, Hassler W : Complication of burr-hole craniostomy and closed-system drainage for chronic subdural hematomas : a retrospective analysis of 376 patients. Neurosurg Rev 25 : 89-94, 2002 | 미소장 |
| 18 | Sambasivan M : An overview of chronic subdural hematoma : experience with 2300 cases. Surg Neurol 47 : 418-422, 1997 | 미소장 |
| 19 | Santarius T, Hutchinson P J : Chronic subdural haematoma : time to rationalize treatment? Br J Neurosurg 18 : 328-332, 2004 | 미소장 |
| 20 | Stanisic M, Lund-Johansen M, Mahesparan R : Treatment of chronic subdural hematoma by burr-hole craniostomy in adults : influence of some factors on postoperative recurrence. Acta Neurochir (Wien) 147 : 1249-1256; discussion 1256-1257, 2005 | 미소장 |
| 21 | Nonsurgical treatment of chronic subdural hematoma. |
미소장 |
| 22 | Number of burr holes as independent predictor of postoperative recurrence in chronic subdural haematoma. |
미소장 |
| 23 | Efficacy of closed-system drainage in treating chronic subdural hematoma |
미소장 |
| 24 | Weber G : [Chronic subdural hematoma.] Schweiz Med Wochenschr 99 : 1483-1488, 1969 | 미소장 |
| 25 | Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S : Independent predictors of recurrence of chronic subdural hematoma : results of multivariate analysis performed using a logistic regression model. J Neurosurg 98 : 1217-1221, 2003 | 미소장 |
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