Chronic Subdural Hematoma
Conditions
Brief summary
This study aims to evaluate and compare the clinical and radiological outcomes of patients with chronic subdural hematoma (CSDH) undergoing surgical evacuation using either single or double burr-hole craniostomy. The comparison focuses on key outcome measures including recurrence rate, postoperative complications, neurological improvement, length of hospital stay, and overall functional recovery, in order to determine the most effective and safe surgical technique.
Interventions
PROCEDUREChronic Subdural Hematoma Evacuation
Single burr-hole technique: A single burr hole was made over the maximum thickness of the hematoma followed by dural opening, irrigation with warm saline, and placement of a drain. Double burr-hole technique: Two burr holes were created (frontal and parietal), allowing more extensive irrigation and evacuation of the hematoma, followed by drain placement.
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged ≥18 years * Radiologically confirmed chronic subdural hematoma by CT and/or MRI * Symptomatic patients indicated for surgical evacuation * Patients treated by burr-hole craniostomy (single or double)
Exclusion criteria
* Acute or subacute subdural hematomas * Patients managed by craniotomy flap * Uncorrected coagulopathy * Patients on anticoagulant or antiplatelet therapy without proper perioperative management * Patients with severe comorbid conditions significantly affecting outcomes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recurrence | 6 months | re-accumulation requiring re-operation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Infection | 6 months | invasion and multiplication of pathogenic microorganisms in a host, causing a local or systemic immune response, which may or may not result in clinical disease. |
| Seizures | 6 months | sudden, uncontrolled electrical disturbance in the brain that can cause changes in behavior, movement, sensation, consciousness, or autonomic function |
| Pneumocephalus | 6 months | presence of air within the intracranial cavity |
| Glasgow Coma Scale | 6 months | evaluate the level of consciousness in patients with acute brain injury by assessing three components: eye opening, verbal response, and motor response.score ranges from 3 to 15, with lower scores indicating more severe impairment of consciousness. |
| Motor Power | 6 months | strength generated by voluntary contraction of a muscle or muscle group and is assessed during neurological examination to evaluate the integrity of the motor system. It is commonly graded using the Medical Research Council (MRC) Muscle Strength Scale.ranging from 0 (no contraction) to 5 (normal strength), with higher vlaues indicating better outcomes. |
Countries
Egypt
Outcome results
None listed