Hostname: page-component-77c89778f8-gvh9x Total loading time: 0 Render date: 2024-07-19T09:32:58.163Z Has data issue: false hasContentIssue false
  • English
  • Français

One Versus Double Burr Holes for Treating Chronic Subdural Hematoma Meta-Analysis

Published online by Cambridge University Press:  23 September 2014

Sirajeddin Belkhair  and
Gwynedd Pickett
Sirajeddin Belkhair*
Affiliation:
Division of Neurosurgery, Dalhousie University, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada
Gwynedd Pickett
Affiliation:
Division of Neurosurgery, Dalhousie University, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada
*
Sirajeddin Belkhair, QE II Health Sciences Centre, Halifax Infirmary, 3806 – 1796 Summer Street, Halifax, Nova Scotia, B3H 3A7, Canada Email: sirajeeddin@hotmail.com
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective and Design:

There is controversy among neurosurgeons regarding whether double burr hole craniostomy (DBHC) is better than single burr hole craniostomy (SBHC) in the treatment of chronic subdural hematoma (CSH), in terms of having a lower revision rate. In order to compare the revision rates after SBHC versus DBHC, we performed a meta-analysis of the available studies in the literature.

Materials and Methods:

Multiple electronic health databases were searched to identify all the studies published between 1966 and December 2010 that compared SBHC and DBHC. Data were processed in Review Manager 5.0.18. Effect sizes were expressed in pooled odds ratio (OR) estimates, and due to heterogeneity between studies we used random effect of the inverse variance weighted method to perform the meta-analysis.

Results:

Five observational retrospective cohort studies were identified: four published studies and one unpublished, describing the outcomes of 355 DBHC and 358 SBHC to evacuate 713 CSH in 631 patients. Meta-analysis showed that there was no significant difference in the revision rates between double burr hole craniostomy and single burr hole craniostomy when performed to evacuate CSH. Pooled odds ratio for all the studies was 0.62 (95% confidence interval 0.26 - 1.46).

Conclusions:

The results of this meta-analysis suggest that SBHC is as good as DBHC in evacuating chronic subdural hematoma and is not associated with a higher revision rate compared to DBHC.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 1 , January 2013 , pp. 56 - 60
Copyright
Copyright © The Canadian Journal of Neurological 2013

References

1. Weigel, R, Schmiedek, P, Krauss, JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J NeurolNeurosurg Psychiatry. 2003 Jul;74(7):937–43.CrossRefGoogle ScholarPubMed
2. Kansal, R, Nadkarni, T, Goel, A. Single versus double burr hole drainage of chronic subdural hematomas. A study of 267 cases. J ClinNeurosci. 2010 Apr;17(4):428–9.Google Scholar
3. Lee, JK, Choi, JH, Kim, CH, Lee, HK, Moon, JG. Chronic subdural hematomas: a comparative study of three types of operative procedures. J Korean Neurosurg Soc. 2009 Sep;46(3):210–14.Google Scholar
4. Taussky, P, Fandino, J, Landolt, H. Number of burr holes as independent predictor of postoperative recurrence in chronic subdural haematoma. Br J Neurosurg. 2008 Apr;22(2):279–82.CrossRefGoogle ScholarPubMed
5. Vignes, JR. Surgical treatment of chronic subdural hematoma in the adult. Review of the literature. Neurochirurgie. 2001 Nov;47(5):479–87.Google Scholar
6. Gelabert-Gonzalez, M, Iglesias-Pais, M, Garcia-Allut, A, Martinez-Rumbo, R. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg. 2005;107(3):223–9.Google Scholar
7. Cenic, A, Bhandari, M, Reddy, K. Management of chronic subdural hematoma: a national survey and literature review. Can J Neurol Sci. 2005 Nov;32(4):501–6.Google Scholar
8. Rohde, V, Graf, G, Hassler, W. Complications of burr-hole craniostomy and closed-system drainage for chronic subdural hematomas: a retrospective analysis of 376 patients. Neurosurg Rev. 2002 Mar;25(1-2):89–94.Google Scholar
9. Okada, Y, Akai, T, Okamoto, K, Iida, T, Takata, H, Iizuka, H. A comparative study of the treatment of chronic subdural hematoma-burr hole drainage versus burr hole irrigation. Surg Neurol. 2002 Jun;57(6):405–9; discussion 410.Google Scholar
10. Lega, BC, Danish, SF, Malhotra, NR, Sonnad, SS, Stein, SC. Choosing the best operation for chronic subdural hematoma: a decision analysis. J Neurosurg. 2010 Sep;113(3):615–21.CrossRefGoogle ScholarPubMed
11. Han, HJ, Park, CW, Kim, EY, Yoo, CJ, Kim, YB, Kim, WK. One vs. two burr hole craniostomy in surgical treatment of chronic subdural hematoma. J Korean Neurosurg Soc. 2009 Aug;46(2):87–92.Google Scholar
12. Oishi, M, Toyama, M, Tamatani, S, Kitazawa, T, Saito, M. Clinical factors of recurrent chronic subdural hematoma. Neurol Med Chir. 2001 Aug;41(8):382–6.Google Scholar
13. Santarius, T, Kirkpatrick, PJ, Ganesan, D, Chia, HL, Jalloh, I, Smielewski, P. use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet. 2009;374:1067–73.Google Scholar