CARBON-DIOXIDE GAS REPLACEMENT OF CHRONIC SUBDURAL-HEMATOMA USING SINGLE BURR-HOLE IRRIGATION

In order to achieve complete irrigation, reduce air in the hematoma ca vity, and obtain rapid reduction of the cavity without drainage, we us e burr-hole evacuation of the hematoma followed by irrigation using ph ysiologic saline solution and replacement of the hematoma with carbon dioxide (CO2) gas. We have treated 19 cases between the ages of 41 and 84. With the exception of one case with dementia of 5 years' duration , all cases were asymptomatic postoperatively. Computed tomography (CT ) scans obtained immediately postoperatively showed the gas to fill th e hematoma cavity, but on the following day, the gas and the hematoma cavity had nearly disappeared. There was no surgical mortality nor mor bidity and there were no side effects of the CO2 gas. Recurrence was f ound in one case (5.3%). By filling the hematoma cavity with CO2, disa ppearance of the cavity is rapid and drainage is not needed. Moreover, this technique implies no restrictions on postoperative motility, and is thus suitable for elderly patients.