Chronic subdural hematoma surgery [Neurosurgery Wiki]

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====== Chronic subdural hematoma surgery ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/12KS9FYSUmvhjssGCdQXzUP7v9sUpkvxuimNEgw6H57OTxXQ42/?limit=15&utm_campaign=pubmed-2&fc=20221213100824}}

[[Chronic subdural hematoma]] (CSDH) [[evacuation]] is one of the most frequent surgical [[procedure]]s in neurosurgery
((S.A. Almenawer, F. Farrokhyar, C. Hong, W. Alhazzani, B. Manoranjan,
B. Yarascavitch, P. Arjmand, B. Baronia, K. Reddy, N. Murty, S. Singh, Chronic
subdural hematoma management: a systematic review and meta-analysis of 34,829
patients, Ann. Surg. 259 (2014) 449–457, https://doi.org/10.1097/SLA.
0000000000000255.)).

===== Indications =====

[[Chronic Subdural Hematoma Surgery Indications]].


===== Chronic subdural hematoma surgical techniques =====

see [[Chronic subdural hematoma surgical technique]]s.

===== Routine postoperative CT =====

Routine post-operative CT brain for [[burr hole]] drainage of CSDH may be unnecessary in view of the good predictive value of pre-operative volume, and also because it is not predictive of the clinical outcome
((Ng HY, Ng WH, King NK. Value of routine early post-operative computed tomography in determining short-term functional outcome after drainage of chronic subdural hematoma: An evaluation of residual volume. Surg Neurol Int. 2014 Sep 19;5:136. doi: 10.4103/2152-7806.141299. eCollection 2014. PubMed PMID: 25298918.)).

Scheduled postoperative cranial imaging with indwelling drains was not shown to be beneficial and misses information of intracranial damage inflicted by removal of drains. Brokinkel et al recommend CT-scanning after drainage removal
((Brokinkel B, Ewelt C, Holling M, Hesselmann V, Heindel WL, Stummer W, Fischer 
BR. Routine postoperative CT-scans after burr hole trepanation for chronic
subdural hematoma - better before or after drainage removal? Turk Neurosurg.
2013;23(4):458-63. doi: 10.5137/1019-5149.JTN.7269-12.0. PubMed PMID: 24101264.
)).


===== Complications =====

see [[Chronic subdural hematoma surgery complication]].

[[Chronic subdural hematoma outcome]]