Subgalial Suction Drain versus Subdural Drain in Chronic Subdural Hematoma
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- Category: Vol. 85, March 2017
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Subgalial Suction Drain versus Subdural Drain in Chronic Subdural Hematoma, OSAMA M. ABD EL-WAHAB and AHMED S.K. ABD EL-WAHED
Abstract
Background: Chronic Subdural Hematoma (CSDH) is a common type of intracranial hemorrhage predominantly seen in the elderly. Urgent burr hole evacuation and closed drainage is the most accepted method for treatment. Both subgalial suction and subdural drains were widely used.
Objectives: This study aimed to compare subgalial suction, and subdural drains in treatment of chronic SDH regarding the clinical and radiological outcomes.
Patients and Methods: Medical records of twenty two patients with chronic SDH admitted to Cairo University Hospital during the period from July 2014 to June 2015 were collected, patients were divided into two groups; Group I: Twelve patients where a suction subgalial drain was used, Group II: Ten patients, where a subdural drain was used, all patients were followed-up for a minimum of 3 moths period, and were retrospectively reviewed as regard details of clinical presentation, surgical aspects, clinical and radiological out-comes.
Results: There were thirteen males and nine females with mean age 64.8 years, range (49-81 years). The main presen-tation was weakness in seventeen patients (77%), followed by headache, which was associated with weakness in thirteen patients (59%), alone in three patients (13.6%), two patients (9%) presented with disturbed level of consciousness. Twenty one patients (95%) showed clinical improvement. Radiological evidence of recurrence occurred in one patient from Group I, which was asymptomatic, with no further operation needed during 3 months follow-up period. Morbidity occurred in one patient from Group II in the form of superficial wound infec-tion, which responded to conservative management. A single mortality case in this series from Group II didn't survive due to his bad chest condition.
Conclusion: Subgalial and subdural drains are both safe and effective methods for drainage after evacuation of CSDH, with no statistical difference in clinical outcomes. Subdural drain could be associated with less radiological recurrence.