Chronic Subdural Hematoma Treated by Burr Holes and Closed Drainage System: A Review of 630 Cases

Objectives: To study the clinical features and surgical results of patients with chronic subdural hematoma. Methods: A retrospective study of the records of 630 patients treated surgically for chronic subdural hemato- ma using a burr hole and closed drainage system was conducted. Results: Six hundred and thirty patients (438 males and 192 females) ranging from 12 to 100 years with a mean age of 66.7 years were identified. Upon admission, 242 (38%) patients were in satisfactory condi- tion (grades 0-1), 262 (42%) patients were at grade 2 and 126 (20%) were at grades 3 or 4. In 5.3% of the patients, surgical intervention was required to remove a recurring hematoma. In 77% of the patients, the results achieved could be graded as good (grades 0-1), with mortality being 2.5%. The only factor affecting the outcome was the grade at admission (p ! 0.05). Conclusion: A simple and routinely used burr hole procedure either under local or general anesthesia with a closed drainage sys- tem is a safe and effective procedure for the treatment of chronic subdural hematoma.