THE SINGLE BURR HOLE TECHNIQUE FOR THE EVACUATION OF NONACUTE SUBDURAL HEMATOMAS

A 4-year retrospective study was made of 111 consecutive surgically tr eated patients with chronic or subacute subdural hematomas. All underw ent single burr hole evacuation with accompanying saline irrigation of the subdural space. Postoperative outcomes at 6 weeks were 90% excell ent, 5.5% fair, and 4.5% poor. Postoperative re-evacuation was perform ed either by needle aspiration or reoperation via the burr hole on 12 patients; one required a craniectomy and neomembrane stripping. These results compare favorably with previous data and support the use of th e single burr hole technique as a simple and effective treatment of su bacute and chronic subdural hematomas. This addresses the decompressio n of the brain parenchyma, the removal of the residual semisolid subdu ral hematoma component and the removal, dilution, and inactivation of endogenous fibrinolytic agents.