title: Chronic subdural hematoma--craniotomy versus burr hole trepanation.
abstract: The authors present a series of more than 200 surgical procedures for chronic subdural hematoma in a 5-year-period. Clinical presentation and neurosurgical treatment were regarded with a special focus on the surgical technique. Between March 2003 and July 2008, 193 patients (113 male and 80 female, mean age 72.5 yrs [range 26-97 yrs]) suffering from chronic subdural hematoma were retrospectively analyzed. One-hundred-fifty-one craniotomies and 42 burr holes were performed. Forty-two craniotomy patients (27.8%) in contrast to 6 burr hole patients (14.3%) required surgical revision. A craniectomy was performed as an ultima ratio after at least 2 prior evacuations in 3 cases. Chronic subdural hematoma is a disease of the elderly. A craniotomy seems to possess a higher rate of recurrence of the chronic subdural hematoma so that a burr hole evacuation should be preferred. Craniectomy might be a good therapeutic option in complicated recurrent chronic subdural hematomas.
authors.affiliation: Department of Neurosurgery, Hannover Nordstadt Hospital, Klinikum Hannover, 30167 Hannover, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Mondorf
authors.forename: Muaath
authors.initials: M
authors.lastname: Abu-Owaimer
authors.forename: Michael R
authors.initials: MR
authors.lastname: Gaab
authors.forename: Joachim M K
authors.initials: JM
authors.lastname: Oertel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000379:methods*; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014207:Trephining / Q000379:methods*