Effect of Intra-operative Saline Irrigation during Burr Hole Surgery on the Recurrence for Chronic Subdural Hematomas

Abstract

Objective: The aim of this study is to compare the postoperative recurrence rates and alteration in follow-up brain CT radio-graphic results between patients with chronic subdural hematoma (CSDH) treated by burr hole trephination with or without irrigation during the surgery. Methods: A total of 100 patients diagnosed with CSDH underwent burr hole trephination from January 2013 to May 2015. The patients were divided into two groups: those who underwent intra-operative saline irrigation and those who did not. Difference in the rate of symptomatic recurrence requiring second surgery between the two groups was evaluated. Radiogra-phic results were analyzed based on the patients' follow-up brain CTs taken 1 month after the surgery. Results: Sixty eight patients underwent intra-operative irrigation while 32 patients did not. The median ages of the two groups were 69.6 years (range, 39-91 years) and 69.1 years (range, 38-86 years), respectively. Among the "irrigated" group, six patients required second surgery due to recurrent hematoma (8.8%) while nine patients in the "not irrigated" group underwent second surgery (28.1%). Difference in the Glasgow coma scale (GCS) between the two groups had no statistical significance. Conclusion: Upon conducting burr hole trephination surgery for CSDH, saline irrigation is a simple procedure that can reduce the recurrence rate.