Outcome of Chronic Subdural Hematoma Management With Double Burr Hole Craniotomy Versus Single Burr Hole Craniotomy and Subdural Drain Evacuation

Services Institute of Medical Sciences, Pakistan60 enrolled

Overview

The goal of this clinical trial is to compare the outcome of double burr hole versus single burr hole in patients of chronic subdural hematoma undergoing subdural drain evacuation. The main questions it aims to answers are 1\. Which one of the surgical method i.e single burr hole or double burr hole is clinically superior with better post operative prognosis for the drainage of chronic subdural hematoma. 2 Compare the post operative complications in both the techniques in term of wound infection hospital stay duration , recurrence and mortality. participants will be divided in two groups one group will be treated with single burr hole technique second group will be treated with double burr hole technique. After procedure, patients will be followed-up in hospital until discharge and total hospital stay will be noted. Patients will be followed-up further in OPD . During follow-up, patients will be evaluated for wound infection, recurrence and mortality.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Chronic Subdural Hematoma

Interventions

Eligibility

Sex: ALLMin age: 20 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged 20-70 years both genders diagnosed with subdural hematoma Exclusion Criteria: * • Patients in shock (BP≤100/60 mmHg) or history of seizures * Patients with bleeding disorder (PT\>15 sec) or intake of anti-coagulants * Patients undergoing or already had ventriculoperitoneal shunt * Patients with epilepsy, or obsessive compulsive decoder * Patients with already operated for subdural hematoma * Patients with post-cerebrospinal fluid diversion subdural hematoma

Outcomes

Primary Outcomes

Recurrence Of Chronic Subdural Hematoma

recurrence rate of chronic subdural hematoma evaluated if volume of sdh \>15ml or significant mass effect on CT brain within 3 months post operatively

Time frame: From date of surgery until radiologically confirmed recurrence (defined as subdural hematoma volume >15 mL or significant mass effect on CT brain) requiring repeat intervention, assessed up to 3 months postoperatively

quantity of hematoma evacuated

Intraoperatively evacuated hematoma quantity measured in millilitres and also includes the quantity obtained in subdural drain till 72 hours postoperatively

Time frame: Measured intraoperatively at the time of surgery and cumulatively measured postoperatively from surgery until removal of the subdural drain, assessed up to 72 hours postoperatively.