Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Treatment Results of Twist-drill Craniostomy with Closed-system Drainage for the Symptomatic Chronic Subdural Hematoma Patients

임상증상을 보이는 만성 경막하혈종 환자에 대한 소천공배액술의 치료결과

  • Lee, Chul-Woo (Department of Neurosurgery, College of Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Hwang, Sun-Chul (Department of Neurosurgery, College of Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Kim, Bum-Tae (Department of Neurosurgery, College of Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Lee, Se-Young (Department of Neurosurgery, College of Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Im, Soo-Bin (Department of Neurosurgery, College of Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Shin, Won-Han (Department of Neurosurgery, College of Medicine, Soonchunhyang University Bucheon Hospital)
  • 이철우 (순천향대학교 의과대학 부천병원 신경외과학교실) ;
  • 황선철 (순천향대학교 의과대학 부천병원 신경외과학교실) ;
  • 김범태 (순천향대학교 의과대학 부천병원 신경외과학교실) ;
  • 이세영 (순천향대학교 의과대학 부천병원 신경외과학교실) ;
  • 임수빈 (순천향대학교 의과대학 부천병원 신경외과학교실) ;
  • 신원한 (순천향대학교 의과대학 부천병원 신경외과학교실)
  • Published : 2005.04.30
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Abstract

Objective: Symptomatic chronic subdural hematoma(CSDH) is a well-known neurosurgical entity and most of the lesion is managed by surgical treatment. The authors analyze the surgical indication and the treatment results of twist drill craniostomy with closed-system drainage(TDD) for the symptomatic CSDH. Methods: From March 2001 through December 2003, 31 patients who were treated with TDD for the symptomatic CSDH and followed more than 6months were included. The radiologic criteria of TDD in this study were 1) homogeneous density of hematoma on computed tomography(CT), 2) no septation of hematoma on magnetic resonance imaging(MRI), and 3) thicker hematoma more than twice thickness of skull. Surgical procedures were performed on the maximum thickness of hematoma on CT/MRI. Short and long Steinman pins were used to penetrate the skull and hematoma membrane. As the 5L catheter was inserted through the drill hole, it was kept for 1 - 7days for the drainage of CSDH. The patients of CSDH were followed with clinical symptoms and CT studies. Results: Most of all the 31 patients were improved. However, one patient was suffered from postoperative epidural hematoma and the other patients have received the secondary operation because of the recurrence of CSDH on 3 months after initial surgery. Conclusion: TDD is safe procedure for the symptomatic CSDH if the patients are selected appropriately.

Keywords

References

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