Minimally invasive decompression of chronic subdural haematomas using hollow screws: efficacy and safety in a consecutive series of 320 cases
- Sandro M. KriegAffiliated withDepartment of Neurosurgery, Technische Universität München
- , Fanny AldingerAffiliated withDepartment of Neurosurgery, Technische Universität München
- , Michael StoffelAffiliated withDepartment of Neurosurgery, Technische Universität München
- , Bernhard MeyerAffiliated withDepartment of Neurosurgery, Technische Universität MünchenDepartment of Neurosurgery, Klinikum rechts der Isar, Technische Universität München Email author
- , Juergen KreutzerAffiliated withDepartment of Neurosurgery, Technische Universität München
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Chronic subdural haematoma (cSDH) is a frequent pathology in neurosurgery. Surgical treatment varies widely and is often characterised by repeated decompression. Therapeutic efficacy was evaluated by clinical symptom relief and haematoma reduction on preoperative and postoperative CT scans.
We investigated a consecutive series of 320 cases of cSDH between 2006 and 2010. In this series, the first- and second-line treatments were performed via hollow-screw placement under local anaesthesia, whereas enlarged burr holes under general anaesthesia were used as third-line treatment.
In general, 63.3% of cases were sufficiently treated by a single operation, while 16.2% needed a second procedure with hollow screws. Only 20.5% needed open surgery by an enlarged burr hole with membranectomy under general anaesthesia. After the first operation, initial symptoms improved in 80.3% of cases, remained unchanged in 15.5% and worsened in 4.2% of cases. Mean age was 74.6 ± 12.1 years, with only one case of severe surgery-related complication.
Initial placement of hollow screws under local anaesthesia is a safe and sufficient treatment in most cases, and should be favoured as first-line treatment in patients with cSDH, since these patients are often of older age and present with distinct comorbidity.
KeywordsChronic subdural haematoma Decompression Hollow screw Drainage
- Minimally invasive decompression of chronic subdural haematomas using hollow screws: efficacy and safety in a consecutive series of 320 cases
Volume 154, Issue 4 , pp 699-705
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- Springer Vienna
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- Chronic subdural haematoma
- Hollow screw
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- Author Affiliations
- 1. Department of Neurosurgery, Technische Universität München, Munich, Germany
- 2. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany