Effectiveness of a single burr hole as a surgical technique for the management of chronic subdural hematoma: A clinical case series study

Chronic subdural haematoma (chSDH) commonly affects the elderly population, and a number of factors are related to its recurrence. As regards the procedure, the percentage of its involvement in the chSDH recurrence must be clarified. Thus, the present study aimed to investigate the factors related to chSDH recurrence and to determine the efficacy and contribution of the single burr hole technique in preventing hematoma recurrence. The present study represents a single-center, retrospective study of chSDH cases who underwent surgical evacuation via single burr hole technique. Statistical analyses were executed using the Statistical Package for the Social Sciences. The Shapiro-Wilk test was used for the evaluation of the normality of the distribution of variables. Fisher's exact test was used for the categorical variables, and continuous data were evaluated with the Mann-Whitney U test. In total, 166 patients were divided into two groups: Group A (154 patients, 92.8%) without hematoma recurrence, and Group B (12 patients, 7.2%) with hematoma recurrence. All patients were re-operated on, only when they had clinical and radiological deterioration. In the present study, the hematoma recurrence rate using single burr hole surgery for chSDH evacuation was 7.2%, and was relatively small compared with other procedures reported in the literature. Overall, the patients who underwent single burr hole surgery for chSDH evacuation had an increased risk of hematoma recurrence, when this was in combination with anticoagulant use, history of a brain stroke event, and mixed hematoma density observed in CT scans. Notably, in the case of recurrence, the potential interval for recurrence was 16 days following the initial surgical evacuation of the hematoma.