A Systematic Review of Drainage Versus No Drainage Following Burr-Hole Evacuation in Chronic Subdural Hematoma

Abstract

Background: Chronic subdural hematoma (cSDH) is a prevalent neurosurgical issue that can lead to significant morbidity and mortality. Recurrence rates following surgical evacuation range from 5% to 30%, prompting exploration into the potential benefits of drainage in mitigating this risk. This study aims to assess the impact of employing drainage compared to non-drainage on recurrence and mortality rates, as well as overall clinical outcomes in patients with cSDH. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2011 and 2024. Result: The study conducted a comprehensive review of over 4000 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Following an initial screening, five publications were identified as warranting more in-depth analysis. Consequently, a thorough review of these selected studies was performed to ensure a detailed and rigorous evaluation. Conclusion: The findings indicate that implementing drainage after burr-hole irrigation significantly decreases the rates of recurrence, mortality, and gross focal neurological deficits associated with chronic subdural hematomas. These results support the use of drainage as a beneficial intervention in the management of cSDH, contributing to improved patient outcomes.