title: Comparison of the Outcomes and Recurrence with Three Surgical Techniques for Chronic Subdural Hematoma: Single, Double Burr Hole, and Double Burr Hole Drainage with Irrigation.
abstract: OBJECTIVE
  Chronic subdural hematoma (CSDH), a disease commonly encountered by neurosurgeons, is treated by burr hole drainage (BHD). However, the optimal surgical technique among the three types of BHD has not been determined.
  
  
  METHODS
  We conducted a retrospective study on BHD performed on 93 patients who were diagnosed with CSDH. The subjects were divided into three groups based on the surgical technique performed: single BHD without irrigation (Group A, n=31), double BHD without irrigation (Group B, n=32), and double BHD with irrigation (Group C, n=30). The clinical factors, radiological factors and recurrences were compared between the three groups. Moreover, independent factors affecting the recurrence were analyzed.
  
  
  RESULTS
  The change in hematoma thickness was 29.77±7.94%, 49.73±12.87%, and 75.29±4.32% for Group A, B, and C, respectively, while the change in midline shift was 40.81±15.47%, 51.78±10.94%, and 56.16±16.16%, respectively. Thus, Group C showed the most effective for resolution of hematoma and midline shift (p<0.05). Group A, B, and C had 12 cases (38.7%), 8 cases (25.0%), and 3 cases (10.0%) of recurrences, respectively. Group C had a statistically significantly fewer recurrence rate than Group A (p<0.05). Double burr hole, irrigation, and coagulopathy were each identified as independent factors that reduce recurrence (p<0.05).
  
  
  CONCLUSIONS
  Among the three techniques, the double BHD with saline irrigation resulted in the fewest recurrences. It is probably the most effective technique for preventing the recurrence of CSDH.
authors.affiliation: Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
authors.forename: Kyoung-Min
authors.initials: KM
authors.lastname: Jang
authors.affiliation: Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
authors.forename: Jeong-Taik
authors.initials: JT
authors.lastname: Kwon
authors.affiliation: Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
authors.forename: Sung-Nam
authors.initials: SN
authors.lastname: Hwang
authors.affiliation: Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
authors.forename: Yong-Sook
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
authors.forename: Taek-Kyun
authors.initials: TK
authors.lastname: Nam
keywords: Drainage; Hematoma, subdural, chronic; Therapeutic irrigation; Trephining