Document Detail


Chronic subdural hematoma: evaluation of the clinical significance of postoperative drainage volume.
MedLine Citation:
PMID:  11059660     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: A wide variation in postoperative drainage volumes is observed during treatment of chronic subdural hematoma (CSDH) with twist-drill or burr-hole craniostomy and closed-system drainage. In this study the authors investigate the causes of the variation, the clinical significance thereof, and its influence on treatment outcome. METHODS: A total of 175 cases were investigated between January 1991 and December 1997. Of these, 145 patients had surgery for CSDH, of whom 30 had bilateral lesions. The cases of CSDH were divided into five subtypes (low-density, isodense, high-density, mixed-density, and layering types) on the basis of the brain computerized tomography (CT) findings. Burr-hole craniostomies with closed-system drainage were performed in all patients and the drainage was maintained for 5 days, during which daily amounts of fluid were measured. The mean drainage volume over 5 days was 320 ml, with the largest volume (413 ml) seen in the low-density type and the smallest (151 ml) in the mixed-density type of CSDH. There were recurrences in six patients (seven instances, 4%). The mixed-density type had the highest recurrence rate (8.6%), whereas there was no recurrence for the low-density type. There were no recurrences in 81 patients in whom the total drainage volumes for 5 days were more than 200 ml, but there were recurrences in six (seven instances) of 94 patients in whom the total drainage volume was less than 200 ml. CONCLUSIONS: The postoperative drainage volumes varied greatly because of differences in the outer membrane permeability of CSDH, and such variation seems to be related to the findings on the CT scans obtained preoperatively. Patients with CSDH in whom there is less postoperative drainage than expected should be carefully observed, with special attention paid to the possibility of recurrence.
Authors:
T H Kwon; Y K Park; D J Lim; T H Cho; Y G Chung; H S Chung; J K Suh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  93     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-03     Completed Date:  2000-11-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  796-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, College of Medicine, Korea University, Seoul.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Craniotomy
Drainage*
Exudates and Transudates / metabolism*
Female
Hematoma, Subdural, Chronic / diagnosis*,  metabolism*,  surgery
Humans
Male
Middle Aged
Postoperative Care / methods*
Recurrence
Comments/Corrections
Comment In:
J Neurosurg. 2001 Oct;95(4):725-6   [PMID:  11596974 ]

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