gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Low vacuum drainage for treating chronic subdural haematoma

Niedervakuumdrainage in der Behandlung des chronisch subduralen Hämatoms

Meeting Abstract

  • corresponding author Dirk Freudenstein - Klinik für Neurochirurgie, Eberhard Karls Universität, Tübingen
  • M. Merkle - Klinik für Neurochirurgie, Eberhard Karls Universität, Tübingen
  • R. Ritz - Klinik für Neurochirurgie, Eberhard Karls Universität, Tübingen
  • F. Duffner - Klinik für Neurochirurgie, Eberhard Karls Universität, Tübingen
  • J. Trübenbach - Abteilung für Neuroradiologie, Eberhard Karls Universität, Tübingen
  • M. Tatagiba - Klinik für Neurochirurgie, Eberhard Karls Universität, Tübingen

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 12.129

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0413.shtml

Veröffentlicht: 23. April 2004

© 2004 Freudenstein et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Chronic subdural haematoma (CSDH) is one of the commonest disorders requiring neurosurgery. It is largely a disorder of old age. The authors report the use of low vacuum drainage in burr hole craniostomy for CSDH.

Methods

Eighty-nine patients with CSDH were operated via a burr hole craniostomy with closed subdural drainage system and irrigation between August 2001 and September 2003. In 21 cases (15 males and 6 females; age range 40 to 88 years; mean 70 years) a low vacuum drainage (LVD) was used. These patients included 3 bilateral haematomas. In the other 68 cases including 10 bilateral haematomas (45 males and 23 females; age range 34 to 95 years; mean 72 years) a standard drainage bag (SDB) was used. Except for the collection system, there was no difference regarding the surgical technique. In a retrospective study the patient files were analysed. The usefulness of LVD was evaluated by comparing clinical and neuroradiological data from the two groups pre- and postoperatively.

Results

No postoperative complications such as infection or intracerebral haemorrhage arose in either group. In both groups neurological symptoms such as hemiparesis, headache or disturbed consciousness disappeared in 85% of the cases soon after surgery. Drainage was removed within 3 days of surgery in the SDB group and in 2 days in the LVD group. The rate of intracranial air intrusion and later residual haematoma was lower for the LVD group. In the LVD group 1 patient (5%) required further surgical intervention because of symptomatic reaccumulation of the CSDH, whereas 5 patients (7%) had to be operated again in the SDB group.

Conclusions

Using a low vacuum drainage system for burr hole craniostomy shortens the duration of draining and seems to reduce the rate of recurrence without additional risk of complication compared with standard drainage bags. According to the literature, the data support the thesis that reduction or prevention of intracranial air might help to prevent recurrence.