Efficacy of Subperiosteal Drains in Chronic Subdural Hematoma: A Prospective Randomized Single-Center Study

Bozhkov Y, Feulner J, Buchfelder M, Kleiß MA, Brandner S, Kinfe TM (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Journal of Neurological Surgery Part A: Central European Neurosurgery Thieme

Abstract

Background Chronic subdural hematomas (cSDHs) are most frequently treated by evacuation via a burr-hole craniostomy procedure. Subperiosteal drains have been introduced as alternatives to subdural ones, but only a few prospective studies have explored their efficacy. Thus, a prospective randomized trial was designed to assess their use. Methods The study enrolled patients with newly diagnosed surgically amenable cSDH. These patients were randomized into two groups. The first group underwent cSDH evacuation via a single burr hole craniostomy procedure, followed by placement of a subperiosteal drain; the second group underwent the identical procedure without drain placement. Patient demographics, drain volumes, duration of drainage, cSDH recurrence, and postoperative outcomes were recorded. Results Eighty-eight patients presenting with cSDH (12 with bilateral cSDHs) from a total of 100 surgical cases were enrolled. Nine patients (1 bilateral) were lost to followup. Of all remaining 90 procedures, 37 were carried out with drain placement and the remaining 53 without drain placement. There were five recurrent cases (13.5%) in the drain placement group and 17 (32.1%) in the group without drain placement. This resulted in a statistical significance (odds ratio [OR]: 0.33; p < 0.05) favoring the use of a drain. Conclusion Subperiosteal drain placement can be used safely and effectively to treat cSDH in conjunction with a burr-hole craniostomy procedure, significantly reducing the rate of recurrence without any additional disadvantages.

Authors with CRIS profile

Julian Feulner Lehrstuhl für Innere Medizin V Michael Buchfelder Lehrstuhl für Neurochirurgie Max-Augustus Kleiß Professur für Neurochirurgie mit dem Schwerpunkt Funktionelle Stereotaktische Neurochirurgie Sebastian Brandner Department of Neurosurgery Thomas Mehari Kinfe Professur für Neurochirurgie mit dem Schwerpunkt Funktionelle Stereotaktische Neurochirurgie

How to cite

APA:

Bozhkov, Y., Feulner, J., Buchfelder, M., Kleiß, M.-A., Brandner, S., & Kinfe, T.M. (2024). Efficacy of Subperiosteal Drains in Chronic Subdural Hematoma: A Prospective Randomized Single-Center Study. Journal of Neurological Surgery Part A: Central European Neurosurgery. https://doi.org/10.1055/a-2418-3682

MLA:

Bozhkov, Yavor, et al. "Efficacy of Subperiosteal Drains in Chronic Subdural Hematoma: A Prospective Randomized Single-Center Study." Journal of Neurological Surgery Part A: Central European Neurosurgery (2024).

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