Thokchom Gojendra Singh1 , Brahmacharimayum Bobby Sarma2 , Laithangbam Pradip Kumar Singh3 , Nongthombam Ratan Singh4 , Mohammad Kamaluddin Vahrott5 , Phindariiaki Wankhar6
BACKGROUND Chronic Sub-Dural Hematoma (CSDH) is one of the most common intracranial lesions. However, there is still some debate regarding the best strategy for treatment. In the present study, we analyzed the need for craniotomy, their indication and surgical outcome. METHODS In this analytical cross-sectional study, 104 patients were subjected to surgery; 81 patients for Burr Hole Drainage (BHD) and 23 patients for Craniotomy with Membranectomy (CWM). Another 120 patients admitted during the study period from January 2012 to December 2016 were excluded from the study on medical grounds. Operative technique was based on the pre-operative radiographic finding and per-operative need. RESULTS Recurrence rate was 4.93% (4 out of 81) in the BHD group and none in the CWM group. Mortality rate was 8.69% (2 out of 23) in the craniotomy group and none in the BHD group. Morbidity is unevenly distributed with pneumoencephalus being higher in the BHD group than CWM group (17.28% versus 13.04%) whereas scalp hematoma (4 cases), wound infection (2 cases) and small subdural bleed (2 cases) were found in the craniotomy group. CONCLUSIONS Despite higher morbidity and mortality, CWM will continue to be an indispensable alternative to BHD in some cases.
