Table 2.
Treatment outcomes of craniotomy with membranectomy for chronic subdural hematoma.
| First Author, Published Year | Intervention Type (n) | Average time from injury to operation | CSDH Grade (n) | Outer vs. Inner membranectomy | Drainage | Average follow up in months | Mortality (%) | Morbidity (%) | Recurrence (%) | Post-op duration in days | Major Complications (n) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Kayaci et al., 201437 | CTIM (144) BCOMI (108) |
N/A | 1 (84) 2 (42) 3 (12) 4 (6) 1 (60) 2 (30) 3 (12) 4 (6) |
Inner Outer |
CSD (144) CSD (108) |
12 | N/A | N/A | 0/144 (0%) 9/108 (8%) |
7 ± 0.1 8.8 ± 0.2 |
N/A |
| Callovini et al., 201438 | CR (34) | N/A | 0 (19) 1 (5) 2 (7) 3 (3) |
Outer | CSD (34) | N/A | 1/34 (3%) | 6/34 (18%) | 2/34 (6%) | N/A | Subarachnoid hemorrhage (1) Stroke (2) Hygroma (1) Cardiopulmonary (2) |
| Lee et al., 200430 | CR (134) BH (38) |
N/A | 0 (41) 1 (77) 2 (43) 3 (2) 4 (9) |
N/A | CSD (134) CSD (38) |
N/A | 8/172 (5%) | 0/172 (0%) | N/A | N/A | Subdural empyema (2) |
| Svien and Gelety, 196439 | CR (19) | 4–7 weeks (*10 days – 1 year) |
N/A | N/A | Penrose drain (19) | 3 | 5/69 (7%) | 3/69 (4%) | 0 (0%) | N/A | N/A |
| Tyson et al., 198040 | CR (7) | 4.4 months | N/A | N/A | CSD (7) | 22.5 | 0 (0%) | 1/7 (14%) | N/A | N/A | Severely disability (1) |
| Sambasiv an, 199741 | CR (2215) BH (60) | N/A | N/A | Inner N/A |
CSD (2215) CSD (60) |
18 | 11/2215 (.5%) 2/60 (3%) |
N/A | 8/2215 (.4%) 11/60 (18%) |
N/A | N/A |
| Mondorf et al., 200942 | CR (151) BH (42) |
N/A | N/A | Inner | CSD (151) CSD (42) |
N/A | 7/151 (5%) 1/42 (2%) |
0/193 (0%) | 42/151 (28%) 6/42 (14%) |
N/A | Seizures (14) |
| Kim et al., 201143 | CR (58) BH (259) |
N/A | 0 (24) 1 (28) 2 (4) 3 (0) 4 (2) 0 (202) 1 (26) 2 (5) 3 (5) 4 (21) |
Outer and inner N/A |
subdural CSD (58) CSD (259) |
6 | 2/58 (3%) 21/259 (8%) |
6/58 (10%) 38/259 (15%) |
12/58 (21%) 23/259 (9%) |
Small CR: 35.6 ± 16.5 Large CR: 33.1 ± 14.5 BH: 35.2 ± 21.9 |
ICH (1) Seizures (2) Pneumonia (3) Infection, pneumocephalus, epidural hematoma, & seizure (9) Pneumonia & sepsis (29) |
| Tanikawa et al., 200144 | CR (16) BH (33) |
N/A | 0 (12) 1 (3) 2 (1) 0 (21) 1 (6) 2 (4) 3 (1) |
Outer and intrahematomal N/A |
CSD (16) CSD (33) |
6 | 0/16 (0%) 1/33 (3%) |
N/A | 0/16 (0%) 4/33 12%) |
16.8 ± 3.6 22.4 ± 15.1 |
N/A |
| Rocchi et al., 200745 | CR (14) | 3.5 weeks | N/A | N/A | CSD (14) | 30.6 | 0/14 (0%) | 0/14 (0%) | 0/14 (0%) | 12 | 0 |
| Gelabert-Gonzalez et al., 200546 | CR (1000) | N/A | N/A | N/A | CSD (1000) | N/A | 21/1000 (2%) | 196/1000 (20%) | 61/1000 (6%) | 7.9 (range: 3–51) | Epilepsy (62) Intracranial hypotension (9) Subdural empyema (7) ICH (4) Peneumocephalus (2) Pneumonia (22) Thromboembolic complications (8) Cardiac issues (11) Sepsis (10) |
| Mohamed, 200947 | CR (39) | N/A | N/A | Outer | Subgaleal suction drainage (39) | 3 | 0 (0%) | 0 (0%) | N/A | N/A | Agitation and delirium (5) 47Seizure (2) 47Chest infection (3) |
| Unterhofe r et al., 201648 | CR (52) | 6.5 weeks (*1–20 weeks) |
0 (12) 1 (29) 2 (15) |
Inner (28) | Subdural Jackson-Pratt (52) | 3–6 weeks | 0 (0%) | N/A | 17/57 (30%) | N/A | Acute subdural bleeding (2) Acute subdural hematoma (1) Seizure (1) |
| Regan et al., 201549 | CR (58) BH (61) |
N/A | N/A | Outer | Subdural CSD (58) Subdural CSD (61) |
No long term follow-up | 4/58 (7%) 2/61 (3%) |
N/A | N/A | 10.3 7.3 |
CR (32/58) Seizure (3) Acute stroke (4) New onset arrhythmia (1) Acute intracranial hemorrhage (10) Deep vein thrombosis/pulmonary embolism (1) Myocardial infarction (1) Respiratory failure (3) Pneumonia (4) Uncomplicated UTI (3) Superficial wound infection (1) BH (13/61) Seizure (1) Acute stroke (2) New onset arrhythmia (1) Acute intracranial hemorrhage (2) Deep vein thrombosis/pulmonary embolism (2) Myocardial infarction (1) Respiratory failure (1) Uncomplicated UTI (2) Cellulitis (1) |
| Van Der Veken et al., 201450 | CR (126) | N/A | 0 (72) 1 (29) 2 (5) 3 (3) 4 (0) |
Outer | Subdural Jackson Pratt (126) | 123.5 weeks (2.6–440 weeks) |
17/126 (13%) | N/A | 11/126 (9%) | 15.4 ± 12.5 | 43/126 Pulmonary infection (24) UTI (9) Decubitus wound (1) Deep venous thrombosis (1) Wound infection (2) Seizure (4) Pneumocephalus (1) Intracerebral hemorrhage (1) |
| White et al., 201051 | CR (116) BH (130) |
N/A | N/A | N/A | CSD (116) CSD (130) |
3 | 20/116 (17%) 10/130 (8%) |
N/A | 23/116 (20%) 23/130 (18%) |
N/A | CR Seizure (10) Subdural empyema (3) BH Seizure (12) Subdural empyema (2) |
| Ernestus et al., 199752 | CR (10) BH (94) |
N/A | 0 (5) 1 (2) 2 (1) 0 (38) 1 (30) 2 (15) 3 (9) |
N/A | CSD (10) CSD (94) |
N/A | 2/10 (20%) 2/94 (2%) |
N/A | N/A | Median: 14 days range:1–71 days | N/A |
Abbreviations: BCOMI = burr hole with craniotomy and membrane incision; CR = craniotomy; ICH = intracerebral hematoma; NA = not available; CSD = closed system drainage.
*
Range reported