BACKGROUND Various modalities have been advocated and practiced to max
imize the effectiveness of treatment for chronic subdural hematoma. Mo
st patients with chronic subdural hematoma are successfully treated wi
th simple burr-hole evacuation and external drainage. Hematomas with t
hick membranes have been found to persist or recur, sometimes necessit
ating reoperation or major surgery; however, they have been satisfacto
rily treated by repeated drainage or tapping as well. Chronic subdural
hematoma can sometimes become an intractable and difficult problem. I
n recurring chronic collections, subdural-peritoneal shunts have been
used as a mode of treatment. Treatment of recurrent subdural collectio
n in infants has been successfully achieved by using subdural-peritone
al shunts. There is also literature to support a similar treatment for
recurrent chronic subdural hematoma in older patients. CASE DESCRIPTI
ON We report a case of recurrent bilateral chronic subdural hematoma i
n an adult, which was successfully managed by repeated burr-hole evacu
ation initially, followed by insertion of a subdural-peritoneal shunt.
The patient did well clinically, and computerized axial tomography di
d not reveal any subdural collection on follow-up. CONCLUSION Treatmen
t of recurrent chronic subdural hematoma is usually straightforward; h
owever, it can sometimes be refractory to regular treatment. In managi
ng such cases, we recommend placement of a subdural-peritoneal shunt i
n preference to a more complicated craniotomy and membranectomy.