A new simple therapeutic method for chronic subdural hematoma without irrigation and drainage.
BACKGROUND
We developed a new simple therapeutic method for the treatment of chronic subdural hematoma (CSDH) without irrigation and drainage. This method is characterized by replacement of the hematoma with oxygen.


METHODS
Seventy patients (seventy-eight sides) with CSDH were treated with this method from May 1994 to October 2002. For the complete replacement of the hematoma with oxygen, subdural tapping site was changed from the thickest area of the hematoma to the parietal tuber. Irrigation and drainage were not used in all patients.


RESULTS
Neurological recovery after the treatment was satisfactory in all 70 patients. An average amount of replaced hematoma was 96.1 ml, ranging from 5 to 280 ml. An initial hematoma pressure ranged from 0 to 200 mm H2O (average: 92.1 mm H2O). During the follow up periods, clinical recurrence was noted in 7 patients (10%) and 7 sides (9.0%).


CONCLUSIONS
The replacement of the hematoma with oxygen via percutaneous subdural tapping without irrigation and drainage is useful and less invasive method for the treatment of CSDH.
Takeda
N
N
Department of Neurosurgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital, and Department of Neurosurgery, Tokyo Women's Medical University, Japan. ntakeda@ohkubohospital.jp
Sasaki
K
K
Oikawa
A
A
Aoki
N
N
Hori
T
T
D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
D010100:Oxygen