ORIGINAL

Analysis of Two Techniques in the Management of Chronic Subdural Hematomas Treated by Burr-Hole Trepanation

Análise de Duas Técnicas no Manejo dos Hematomas Subdurais Crônicos Tratados por Trepanação

  • Bárbara Velani Souza    Bárbara Velani Souza
  • Maria Fernanda Possari Vitro    Maria Fernanda Possari Vitro
  • Maria Paula Marcone Schreiner    Maria Paula Marcone Schreiner
  • Melryan Isabele Giraldi do Carmo    Melryan Isabele Giraldi do Carmo
  • Bruno Moraes de Oliveira    Bruno Moraes de Oliveira
  • Murilo Scapin    Murilo Scapin
  • Sergio Murilo Georgeto    Sergio Murilo Georgeto
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  Downloads: 1

Resumo

Introdução: O hematoma subdural crônico (HSDC) é o acúmulo de sangue entre os folhetos durais decorrente de traumas de crânio. O tratamento predominante é a drenagem cirúrgica com ou sem colocação de dreno pós-operatório. Objetivo: Comparar desfechos clínicos em pacientes com ou sem dreno no pós-operatório. Métodos: Estudo de caso-controle aprovado pelo Comitê de Ética em Pesquisa (CAEE 85976225.0.0000.5231), a partir da análise de prontuários de pacientes submetidos à trepanação do HSDC em Hospital Terciário entre 2020 e 2024, excluídos óbitos nos primeiros 7 dias pós-operatórios. As variáveis analisadas foram epidemiológicas, uso de anticoagulantes, duração do procedimento, infecção em ferida operatória, tempo de internação, tipo de entrada e desfecho. Realizou-se análise estatística através do software SPSS com p<0,05. Resultados: Dentre os 156 pacientes, o uso de dreno esteve associado a um menor tempo de internação e apresentou uma fraca correlação positiva entre idade e tempo internado. Discussão: Consoante à literatura, evidencia o efeito do dreno por promover remoção eficiente do hematoma, prevenção de novo acúmulo e evitar potenciais consequências. Conclusão: O uso de drenagem contínua para o HSDC é superior ao método de drenagem única, devido à melhor evolução clínica e menor tempo de hospitalização.

Palavras-chave

Hematoma subdural crônico; Drenagem; Neurocirurgia

Abstract

Introduction: Chronic subdural hematoma (CSDH) is characterized by the accumulation of blood between the dura mater and the arachnoid, most commonly after trauma. Burr-hole drainage is the standard treatment, whether or not a postoperative drain placement. Objective: To compare clinical outcomes of patients undergoing burr-hole drainage for CSDH, irrespective of postoperative drainage use. Methods: A case– control study was conducted following approval by the Research Ethics Committee (No. 85976225.0.0000.5231). Medical records of patients treated in a tertiary hospital between 2020 and 2024 were reviewed, excluding those who died within the first seven postoperative days. Variables analyzed included epidemiological characteristics, anticoagulant use, procedure duration, surgical site infection, length of hospital stay, type of admission, and clinical outcome. Statistical analyses were performed using SPSS software, with significance set at p < 0.05. Results: Among the 156 patients evaluated, postoperative drainage was associated with a reduced length of hospital stay. A weak positive correlation between age and hospitalization duration was also observed. Conclusion: Postoperative drain placement in the management of CSDH was associated with better clinical outcomes and reduced hospitalization compared with cases managed without drainage.

Keywords

Chronic subdural hematoma; Drainage; Neurosurgery

References

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Londrina, Paraná, Brasil 

E-mail: barbaravelani@gmail.com 

Funding: nothing to disclose.

Conflicts of interest: nothing to disclose.

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1Universidade Estadual de Londrina, Londrina, PA, Brazil.

2Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Universidade Estadual de Londrina, Londrina, PA, Brazil.

3Department of Neurosurgery, Hospital Universitário de Londrina, Londrina, PA, Brazil.

4Neurosurgery Department, Universidade Estadual de Londrina, Londrina, PA, Brazil.

 

Received Dec 28, 2025 

Corrected Apr 12, 2026 

Accepted Apr 18, 2026

JBNC  Brazilian Journal of Neurosurgery

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