Effect of drain placement on postoperative radiology following burrhole drainage of chronic subdural hematoma

Objective: The effect of drain placement on postoperative radiology following burrhole drainage of chronic subdural hematoma (ChSDH) is a topic that has been rarely addressed in literature. The present study was designed to study the effects of postoperative drain placement on different radiological parameters following ChSDH evacuation. Materials & Methods We studied the data of 117 patients operated with burrhole drainage of ChSDH and divided the patients into two groups. In the first group a postoperative subdural drain had been placed while the second was the no drainage group. The pre- and postoperative CT brain of the patients were analyzed and the change in the hematoma width and midline shift was noted. Results: In the drainage group 12 (18.2%) patients had recurrence. In the no drainage group also 12 (23.5%) patiens had recurrence. The difference in recurrence wasn’t significant (p=0.4775). The mean change in the width of the hematoma was 0.95 ± 0.37 mm in the drainage group, while in the no drainage group this was 0.51 ± 0.37 mm. This difference was very significant (p < 0.0000001). The mean change in the midline shift was 0.51 ± 0.21 mm in the drainage group, while in the no drainage group this was 0.26 ± 0.22 mm and this difference again was very significant (p < 0.0000001). Conclusion The placement of a subdural drain following burrhole evacuation of ChSDH leads to significantly decreased postoperative hematoma width and mass effect providing the radiological corroboration for drain placement.