Treatment of Subdural Hematoma: Comparative Analysis between Subdural Drainage with Negative Pressure versus other Drainages

Treatment of Subdural Hematoma: Comparative Analysis between Subdural Drainage with Negative Pressure versus other Drainages

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Viridiana Chávez-Gómez
José Chávez-Monter
Jaime Ordoñez-Granja
Yarel Barba-Ruiz
Rafael Avendaño-Pradel
Edgardo Ruiz-García
Carlos Castillo-Rangel

Abstract

Report the recurrence rate of negative pressure subdural drainage (NPSD) versus to other kind of drains (OD). Design and Methods: A study was conducted cross-sectional and we retrospectively analyzed on the database of the neurosurgical service and we looked for all surgical procedures recorded from January 2006 to December 2015. Procedures with preoperative diagnosis of subdural hematoma (SDH) were selected, with a to- tal of 364 interventions, were excluded patients with postoperative diagnosis different from SDH and eliminated those who did not have complete data, recurrence was identified, a statistical analysis was performed describing frequency measurements percentage and standard deviation, RM and chi- square was obtained by software EPIDAT 3.1. 277 surgeries were performed in 230 patients, The population was divided into two groups: the first those interventions with negative pressure subdural drainage versus a second group with other different drains, and finally we compared the recurrence rate in each group, 44 surgeries had recurrence of SDH. The proportion of recurrence was found 16 % of the surgeries, 16 % (n=7) of these were performed with negative pressure subdural drainage and the remaining 84 % (n=37) by other drainage. The reason for prevalence found was 0.36 (95 % CI , 0.15 to 0.85), with statistically significant differences (p = 0.0165). The chi-square was 5.75 for the SDH with NPSD. It was found that patients treated with NPSD have a lower risk of recurrence compared with OD, which acts as a protective factor for patients treated with this type of drain, this is statistically significant.

References

Ahmed, S.; Agrawal, D.; Kale S. S. & Mahapatra, A. K. A comparative study of treatment of chronic subdural hematoma – burr hole drainage versus continuos closes drainage. Indian J. Neurotrauma, 8(1):17-24, 2011.

Algorta, M. & Spagnuolo, E. Hematoma subdural crónico. Modalidades de tratamiento revisión del tema. Propuestas de manejo. Rev. Argent. Neurocir., 24(4):195-205, 2010.

Bellut, D.; Woernle, C. M.; Burkhardt, J. K.; Kockro, R. A.; Bertalanffy, H. & Krayenbühl, N. Subdural drainage versus subperiosteal drainage in burrhole trepanation for symptomatic chronic subdural hematomas. World Neurosurg., 77(1):111-8,2012.

Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. J. Neurotrauma, 24 Suppl. 1:S1-106, 2007.

Chan, D. Y. C.; Woo, P. Y. M. & Poon, W. S. Chronic Subdural Hematoma: To Drain or Not to Drain, This Is the Question. World Neurosurg., 82(6):1007-9, 2014.

Haines, S. J. & Grande, A. W. Subdural Haematoma. En: BJM Best Practice. Web Site, 2015. Disponible en: http://bestpractice.bmj.com Iliescu, I. A. Current diagnosis and treatment of chronic subdural haematoma. J. Med. Life, 8(3):278-84, 2015.

Ivamoto, H. S.; Lemos, H. P. Jr. & Atallah, A. N. Surgical treatments for chronic subdural hematomas: A comprehensive systematic review.World Neurosurg., 86:399-418, 2016.

Kutty, S. A. & Johny, M. Chronic subdural hematoma: a comparison of recurrence rates following burr-hole craniostomy with and without drains. Turk. Neurosurg., 24(4):494-7, 2014.

Lu, T.; Guan, J. & An, C. Preoperative trepanation and drainage for acute subdural hematoma: Two case reports. Exp. Ther. Med., 10(1):225-30,2015.

Palomo, R. J. L.; Ramos, M. V.; Palomo, G. I.; López, C. A. & Santos, A. I. M. Patología forense y neurología asociada de los traumatismos craneoencefálicos. Estudio práctico. Cuad. Med. Forense, 14(52):87-118, 2008.

Sikahall-Menezes, E.; Salazar-Pérez, N. & SandovalBonilla, B. Hematoma subdural crónico. Análisis retrospectivo de una serie de 100 casos. Cir., 76(3):199-203, 2008.

Singh, A. K.; Suryanarayanan, B.; Choudhary, A.; Prasad, A.; Singh, S. & Gupta, L. N. A prospective randomized study of use of drain versus no drain after burr-hole evacuation ofchronic subdural hematoma. Neurol. India, 62(2):169-74, 2014.

Soleman, J.; Taussky, P.; Fandino, J. & Muroi, C. Evidence-Based Treatment of Chronic Subdural Hematoma. En: Sadaka, F. (Ed.). Traumatic Brain Injury. Rijeka, InTech, 2014.

Sousa, E. B.; Brandäo, L. F. S.; Tavares, C. B.; Borges, I. B. C.; Neto, N. G. F. & Kessler, I M. Epidemiological characteristics of 778 patients who underwent surgical drainage of chronic subdural hematomas in Brasília, Brazil. BMC Surg., 13:5,2013.