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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Neurosci+Rural+Pract
2017 ; 8
(3
): 389-394
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gab.com Text
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Single Parietal Burr-hole Craniostomy with Irrigation and Drainage for Unilateral
Chronic Subdural Hematoma in Young Adults 40 Years: A Rationale behind the
Procedure
#MMPMID28694618
Chandran RS
; Nagar M
; Sharmad MS
; Prabhakar RB
; Peethambaran AK
; Kumar S
; Sharma S
; Jain SK
J Neurosci Rural Pract
2017[Jul]; 8
(3
): 389-394
PMID28694618
show ga
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the most common
neurosurgical conditions. It is mostly a disease of elderly population with very
little data about the young patients. There is also the debate regarding
treatment strategies. We decided to determine the overall efficacy of the single
burr-hole craniostomy (SBHC) for unilateral CSDH in young adults <40 years.
SUBJECTS AND METHODS: We performed a retrospective study of young patients
undergoing SBHC for unilateral CSDH between January 2013 and June 2016 at our
institution. Medical records were assessed based on patient characteristics in
the form of sex of the patient, etiology, presenting symptoms, comorbidities, and
signs including Glasgow Coma Scale, computed tomography (CT) brain findings (site
and thickness of SDH with midline shift), and intraoperative presence of
chronic/subacute component. RESULTS: Mean age of the patient was 33.69 years
(range 18-40 years), mean thickness of SDH was 15.47 mm, and mean midline shift
was 11.26 mm. 61.54% patients were male, trauma being the most common etiology
(92.31%) with most common presenting complaint being headache (90.38% patients).
69.23% patients presented within 1 day of onset of symptoms. On CT scan, most of
the patients were having SDH thickness between 11 and 20 mm (67.31%) with midline
shift of 6-10 mm (53.85%). Right-sided SDH was present in 53.85%.
Intraoperatively, 63.46% patients had subacute SDH whereas 34.61% had chronic
component. There were total 2 recurrences (3.85%). CONCLUSIONS: Young adults who
present with unilateral CSDH usually have a history of trauma. They have shorter
duration of symptoms and present mainly with the features of raised intracranial
pressure such as headache and vomiting. SBHC with irrigation and drainage has
excellent result for unilateral CSDH in young adults compared to other methods of
drainage and should be considered treatment of choice unless contraindicated.