Nandigama Pratap Kumar1, Karla Ravi2
Chronic SDH is one of the common neurosurgical conditions requiring surgical treatment. The incidence of chronic SDH is 1.7-18 per 1,00,000 population. The incidence is higher in the elderly patients, i.e. 58 per 1,00,000. Various treatment modalities available for the treatment of chronic SDH indicate that there is no gold standard for the treatment of chronic SDH. Recurrence is the major problem following treatment and can be as high as 30%. Mini craniotomy is one of the surgical options that can offer better view of the subdural space and may allow us to efficiently clear the loculations and haematoma fluid and thereby decreasing the incidence of recurrences and the need for reoperations. Small craniotomies have not been studied well in the literature except for a few publications. In this study, we are comparing mini craniotomy and burr hole evacuation for the treatment of chronic SDH.
MATERIALS AND METHODS
All the patients with chronic subdural haematoma operated between August 2013 and January 2016. Patients with recurrent SDH on the same side and patients who underwent different procedures on either side (in case of bilateral haematomas) were excluded from the study. The patients were operated by two senior surgeons with one surgeon doing burr hole evacuation and another doing mini craniotomy. Preoperative status and postoperative status was analysed.
All the patients were analysed both preoperatively and postoperatively. In both the groups, most of the patients shown improvement following surgery, but recurrences are more in burr hole group when compared to mini craniotomy.
Mini craniotomy allows better view of the subdural space and better evacuation of chronic subdural haematoma. Cure rate is higher with mini craniotomy compared to burr hole evacuation.