【Abstract】Objective: The surgical management
of chronic subdural hematoma (CSDH) is still a controver-
sial issue, and a standard therapy has not been established
because of the unclear pathogenic mechanisms in CSDH.
The intention of this paper is to find a simple and efficient
surgical procedure for CSDH.
Methods: A retrospective study of 448 patients with
CSDH by surgical treatment during 2005 to 2009 was con-
ducted in order to compare the efficiency between two dif-
ferent primary surgical methods, i.e. twist-drill drainage with-
out irrigation in Group A (n=178) and one burr-hole with
irrigation in Group B (n=270). The results were statistically
analyzed.
Results: The reoperation rates in Group A and Group
B were 7.9% and 11.9% respectively. The good outcome
rate was 88.8% and 75.5%, the complication was 7.9% and
20.7% in Group A and Group B, respectively.
Conclusions: The burr-hole drainage with irrigation of
the hematoma cavity is not beneficial to the outcome and
prognosis. Irrigation is not important in the surgical treat-
ment for CSDH. Thus in initial treatment, twist-drill drainage
without irrigation of the hematoma cavity is recommended
because it is relatively safe, time-saving and cost-effective.
Key words: Hematoma, subdural; Brain injury,
chronic; Drainage