Effect of head positioning on outcome after burr hole craniostomy for chronic subdural haematoma.
OBJECTIVE
To determine the effect of position of the patient's head after burr hole craniostomy on the outcome of chronic subdural haematoma, in terms of haematoma efflux, hospital stay and recurrence rate.


METHODS
Quasi experimental.


METHODS
Combined Military Hospital, Rawalpindi, from February 2007 to February 2008.


METHODS
Sixty patients were divided in two equal groups of 30 patients each. Group A patients were kept flat after the burr hole craniostomy and group B patients were kept with head end of bed elevated by 30 degrees. The results were statistically analysed through software SPSS 14.


RESULTS
The mean age was 59.98 +/- 13.7 years. There was predominance of males (M:F=3.2:1). The location of haematoma was frontoparietal in majority (72%), right sided in 31 (51.6%), left sided in 20 (30%) and bilateral in 9 (15%) patients. Average daily output was 152 ml in group A and 142 ml in group B. Haematoma efflux was found to be sufficient in 26 (86.6%) patients of group A and 27 (90%) of group B. Wound infection occurred in 2 patients of group A and 1 in group B. Seizures occurred in 2 patients of group A and 3 of group B. Although, there was longer hospital stay for group A vs. group B (p=0.002), recurrence rate was insignificant amongst the two groups as 10% vs. 13% (p=0.688).


CONCLUSIONS
Assuming a 30 degrees head up position soon after operation in cases of chronic subdural haematoma does not significantly affect the outcome and recurrence.
Ishfaq
Asim
A
Department of Neurosurgery, Combined Military Hospital, Rawalpindi. asimishfaq@gmail.com
Ahmed
Ishfaq
I
Bhatti
Sabir Hussain
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006257:Head; D020200:Hematoma, Subdural, Chronic / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011187:Posture; D001261:Pulmonary Atelectasis / Q000209:etiology; D016896:Treatment Outcome