Turkish Neurosurgery 2022 , Vol 32 , Num 4
A Comparison of Subgaleal Active Drainage and Subdural Passive Drainage and an Analysis of Factors Affecting Chronic Subdural Hematoma Outcomes
Utku OZGEN1,Ilyas DOLAS2,Tugrul Cem UNAL2,Pulat Akin SABANCI2,Aydin AYDOSELI2,Yavuz ARAS2,Achmed ALI3,Emrah KESKIN4,Kemal Tanju HEPGUL2
1Zonguldak Ataturk State Hospital, Department of Neurosurgery, Zonguldak, Turkey
2Istanbul University Istanbul Medical Faculty, Department of Neurosurgery, Istanbul, Turkey
3Istanbul University Istanbul Medical Faculty, Department of Anesthesiology and Reanimation, Istanbul, Turkey
4Bulent Ecevit University, School of Medicine, Department of Neurosurgery, Zonguldak, Turkey
DOI : 10.5137/1019-5149.JTN.37703-22.2 AIM: To analyze and to compare the factors that influence the recurrence of chronic subdural hematoma (CSDH) among patients treated with subdural non-suction-assisted passive drainage, subgaleal suction-assisted active drainage, and without drainage.

MATERIAL and METHODS: We retrospectively evaluated 87 surgical patients with a diagnosis of CSDH treated between 2007 and 2018 using patient records from the neurosurgery archive of our faculty. The patients were divided into three groups: drainfree group (group A), subdural passive drainage group (group B), and subgaleal active drainage group (group C). Recurrence was defined as an increase in hematoma volume on imaging and persistence of the patient?s symptoms.

RESULTS: Patients with double-membrane CSDH exhibited higher recurrence rates (p=0.043) and those with low-density CSDH exhibited lower recurrence rates (p=0.015) compared to the other patients. No relationship was found between the number of burr holes made and CSDH recurrence (p=0.177). Group C showed the lowest recurrence rate (13.3%), but the differences between groups were not statistically significant.

CONCLUSION: Hematoma density, membrane type, postoperative Glasgow Outcome Scale scores, and postoperative drainage time were found to be statistically significant predictors of recurrence. Burr-hole craniotomy with subgaleal active drainage is a safe and effective method for preventing CSDH recurrence and carries a reduced risk of parenchymal injury. Keywords : Recurrence, Hematoma density, Subdural drain, Subgaleal drain

Corresponding author : Utku OZGEN, utkuozgen3661@gmail.com