Comparing Clinical Responses to Using One Burr Hole and Two Burr Holes to Treat Chronic Subdural Hematoma

Abstract

The therapeutic strategies currently used to treat chronic subdural hematoma (CSDH)
include various methods such as craniotomy and twist drill or utilizing Burr hole. The
present research seeks to make a clinical comparison between using one burr hole and
two burr holes to treat CSDH. This is a randomized, double-blind clinical trial conducted
on 70 patients suffering from CSDH candidated for using burr hole. The participants
were divided into two equal groups and underwent treatment with 1 burr hole or 2
burr holes. The primary and secondary outcome variables were compared across the
two groups prior to and 48 hours following the operation. A total number of 5 death
cases were (7.14%) were reported among patients. 2 patients (5.71%) were in the 1 burr
hole group, while 3 (8.57%) were in the 2 burr hole group (P = 0.514). The need for
undergoing a secondary operation in the 2 burr holes group (1 case, i.e. 2.85%) was
significantly less than what was reported in the other group (6 cases, i.e. 17.14%) (P =
0.012). The mean time of hospitalization (1 burr hole: 4.98, 2 burr holes: 3.1, P = 0.001),
the pneumosephalus levels 48 hours following the operation (1 burr hole: 9.38, 2 burr
holes: 5.91, P = 0.012) and hematoma levels 48 hours following the operation (1 burr
hole: 41.57, 2 burr holes: 30.85, P = 0.0001) in the 2 burr holes group were significantly
less than what were reported in the other group. 48 hours after the operation, the
hematoma volume (1 burr hole: P= 0.031, 2 burr holes: P= 0.002) in both groups
exhibited a significant reduction compared to what was observed before the operation.
Using 1 or 2 burr holes are quite useful methods to treat CSDH patients. However, the
clinical outcome of those patients in the 2 burr holes group was much more favorable.