Acta Neurochirurgica

, Volume 154, Issue 4, pp 699–705 | Cite as

Minimally invasive decompression of chronic subdural haematomas using hollow screws: efficacy and safety in a consecutive series of 320 cases

  • Sandro M. Krieg
  • Fanny Aldinger
  • Michael Stoffel
  • Bernhard MeyerEmail author
  • Juergen Kreutzer
Clinical Article



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.


Chronic subdural haematoma Decompression Hollow screw Drainage 



This study was completely financed by institutional grants from the Department of Neurosurgery.

Conflicts of interest



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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Sandro M. Krieg
    • 1
  • Fanny Aldinger
    • 1
  • Michael Stoffel
    • 1
  • Bernhard Meyer
    • 1
    • 2
    Email author
  • Juergen Kreutzer
    • 1
  1. 1.Department of NeurosurgeryTechnische Universität MünchenMunichGermany
  2. 2.Department of NeurosurgeryKlinikum rechts der Isar, Technische Universität MünchenMunichGermany

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