دورية أكاديمية
Drains result in greater reduction of subdural width and midline shift in burr hole evacuation of chronic subdural haematoma.
| العنوان: | Drains result in greater reduction of subdural width and midline shift in burr hole evacuation of chronic subdural haematoma. |
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| المؤلفون: | Glancz, Laurence Johann, Poon, Michael Tin Chung, Hutchinson, Peter John, Kolias, Angelos Georgiou, Brennan, Paul Martin, British Neurosurgical Trainee Research Collaborative (BNTRC) |
| بيانات النشر: | Springer Science and Business Media LLC //dx.doi.org/10.1007/s00701-020-04356-z Acta Neurochir (Wien) |
| سنة النشر: | 2020 |
| المجموعة: | Apollo - University of Cambridge Repository |
| مصطلحات موضوعية: | Burr hole evacuation, Chronic subdural haematoma, Drains, Midline shift, Outcomes, Radiology, Adolescent, Adult, Aged, 80 and over, Drainage, Female, Hematoma, Subdural, Chronic, Humans, Male, Middle Aged, Postoperative Complications, Subdural Space, Trephining |
| الوصف: | BACKGROUND: Drain insertion following chronic subdural haematoma (CSDH) evacuation reduces recurrence and improves outcomes. The mechanism of this improvement is uncertain. We assessed whether drains result in improved postoperative imaging, and which radiological factors are associated with recurrence and functional outcome. METHODS: A multi-centre, prospective cohort study of CSDH patients was performed between May 2013 and January 2014. Patients aged > 16 years undergoing burr hole evacuation of primary CSDH with pre- and postoperative imaging were included in this subgroup analysis. Baseline and clinical details were collected. Pre- and postoperative maximal subdural width and midline shift (MLS) along with clot density were recorded. Primary outcomes comprised mRS at discharge and symptomatic recurrence requiring re-drainage. Comparisons were made using multiple logistic regression. RESULTS: Three hundred nineteen patients were identified for inclusion. Two hundred seventy-two of 319 (85%) patients underwent drain insertion at the time of surgery versus 45/319 (14%) who did not. Twenty-nine of 272 patients who underwent drain insertion experienced recurrence (10.9%) versus 9 of 45 patients without drain insertion (20.5%; p = 0.07). Overall change in median subdural width was significantly greater in the drain versus 'no drain' groups (11 mm versus 6 mm, p < 0.01). Overall change in median midline shift (MLS) was also significantly greater in the drain group (4 mm versus 3 mm, p < 0.01). On multivariate analysis, change in maximal width and MLS were significant predictors of recurrence, although only the former remained a significant predictor for functional outcome. CONCLUSIONS: The use of subdural drains results in significantly improved postoperative imaging in burr hole evacuation of CSDH, thus providing radiological corroboration for their recommended use. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | Print-Electronic; application/pdf |
| اللغة: | English |
| العلاقة: | https://www.repository.cam.ac.uk/handle/1810/307079Test |
| DOI: | 10.17863/CAM.54172 |
| الإتاحة: | https://doi.org/10.17863/CAM.54172Test https://www.repository.cam.ac.uk/handle/1810/307079Test |
| حقوق: | Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.7073AFB3 |
| قاعدة البيانات: | BASE |
| DOI: | 10.17863/CAM.54172 |
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