Burr-hole versus Mini-craniotomy and (fenestration) membranectomy in management of membranous forming CSDH - Sirte experience
DOI:
https://doi.org/10.37375/sjms.v2i1.1590Keywords:
: membranous chronic subdural hematoma, Burr-hole, mini-craniotomy, (fenestration) membraneotomyAbstract
Objective: The best way to treat (membranous forming) chronic subdural hematoma is unknown. Thus, the purpose of this study was to compare single burr-hole drainage with mini-craniotomy in the treatment of (membrane forming) chronic subdural hematoma, taking into account complication and recurrence rates. Method: (7) patients with (membrane forming) CSDH who underwent surgery between January 2018 and June 2022 had their clinical and radiologic records extracted. They account for 2,5% of all CSDH patients (18) treated during the same time period. The cases undergoing various types of surgery were compared in terms of clinical and radiological outcomes. Result: These (7) patients were divided into two groups: group A (4) patients underwent a single burr-hole trepanation, (3) patients underwent mini-craniotomy and (fenestration) membraneotomy, during all procedures, subdural drainage was placed and removed three days later. All patients recovered completely, with only one case in group A having a rest subdural collection and no complications in group B .Conclusion: When compared to burr-hole evacuation, the mini-craniotomy with (fenestration) membraneotomy technique may be superior for the treatment of (membranous forming) CSDH. More subdural space visibility is made possible by the mini-craniotomy, which also enables more aggressive fluid evacuation, better irrigation of the area, the safe fenestration of any membranes that are accessible. Despite the evident limitations of this study, an upcoming effort to evaluate this technique may be merited
References
Panel Giovanni Rocchi MD a, Emanuela Caroli MD a, Maurizio Salvati MD b, Roberto Delfini MD a. Membranectomy in organized chronic subdural hematomas: indications and technical notes, surgical neurology volume 67, issue 4, 2007.
Claudia Unterhofer 1, Christian F Freyschlag 2, Claudius Thomé 2, Martin Ortler. Opening the Internal Hematoma Membrane Does Not Alter the Recurrence Rate of Chronic Subdural Hematomas: A Prospective Randomized Trial, World Neurosurgery, Volume 92, August 2016
J.W. Burke et al. Meninges: benign postoperative enhancement on MR images Radiology,Volume 174, No. 1, 1990
M.M. Cameron Chronic subdural hematoma: a review of 114 cases J Neurol Neurosurg Psychiatry, Volume 41, Issue 9, 1978
T. Becker et al. Das chronische subdural hamatom Dtsch Med Wochenschr 1988
Giovanni Rocchi MD a, Emanuela Caroli MD a, Maurizio Salvati MD b, Roberto Delfini MD a Membranectomy in organized chronic subdural hematomas: indications and technical notes, Surgical Neurology, Volume 67, Issue 4, April 2007, Pages 374-380
Jefferson W. Chen1, Jordan C. Xu1 , Dennis Malkasian1 , Mari A. Perez-Rosendahl 2 and
Diem Kieu Tran1 the minicraniotomy for Csdh Revisited:New Perspectives Aria Nouri a, Renato Gondar a, Karl Schaller, Volume12, May 2021
Torstein Meling. Chronic Subdural Hematoma (cSDH): A review of the current state of the art; Brain and Spine, Volume 1, 2021
Paul Klimo Jr 1, Anne Matthews, Sean M Lew, Marike Zwienenberg-Lee, Bruce A Kaufman. Minicraniotomy versus bur holes for evacuation of chronic subdural collections in infants-apreliminary single-institution experience, JNS Volume 8, Issue 5
Rauhala et al., 2019; Toi et al., 2017; Kudo et al., 1992; Nayil et al., 2012; MORI and MAEDA, 2001. The incidence of chronic subdural hematomas from 1990 to 2015 in defined Finnish population, Volume 132, issue 4, April 2020.
Cousseau et al, Chronic and subacute subdural haematoma. An epidemiological study in a captive population. Revista de neurologia, 32(9), 821-824.
Ducruet et al. . The surgical management of chronic subdural hematoma. Neurosurgical review, 35(2), 155-169
Macdonald and Winn, 2017. Pathophysiology of chronic subdural hematoma R.H. Winn (Ed.), Youmans & Winn Neurological Surgery (seventh ed.), Elsevier (2017)
Yamashima and Friede, 1984. Why do bridging veins rupture into the virtual subdural space? J. Neurol. Neurosurg. Psychiatr, 47 (2) (1984), pp. 121-127
Stanisic, M., Aasen, A. O., Pripp, A. H., Lindegaard, K. F., Ramm-Pettersen, J., Lyngstadaas, S. P., ... & Sæhle, T. 2012. Local and systemic pro-inflammatory and anti-inflammatory cytokine patterns in patients with chronic subdural hematoma: a prospective study. Inflammation Research, 61(8), 845-852.
Edlmann et al., 2017. Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy. J. Neuroinflammation, 14 (1) (2017), p. 108
Lindvall et al., 2009. Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas J. Clin. Neurosci, 16 (10) (2009), pp. 1287-1290
Hossain NM1*, Rashid HM2 , Bhuiyan MS3 , Habib R4 , Mamun AA5 2021. Mini Craniotomy for Chronic Subdural Haematoma: Surgical Outcome from a Single Institution Experience and Predictors of Success, 9(10), 2902–2907
Sambasivan, 1997. An overview of chronic subdural hematoma: experience with 2300 cases, 47(5), 418-422
Gelabert-Gonzalez et al., 2005. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases, Clinical Neurology and Neurosurgery, Volume 107, Issue 3
Ohba et al., 2011. The risk factors for recurrence of chronic subdural hematoma, Neurosurgical Review volume 36, pages145–150
Nakaguchi et al., 2001. Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence, J Neurosurg, 95(2):256-62
Oishi et al., 2001. Clinical Factors of Recurrent Chronic Subdural Hematoma, 41(8)
Ducruet, A. F., Grobelny, B. T., Zacharia, B. E., Hickman, Z. L., DeRosa, P. L., Anderson, K., ... & Connolly, E. S. (2012). The surgical management of chronic subdural hematoma. Neurosurgical review, 35(2), 155-169.
Vikram et al., 2018 Evidence-based diagnosis and management of chronic subdural hematoma: A review of the literature, Journal of Clinical Neuroscience, Volume 50, Pages 7-15