Evidence map›Paper›PMID 40056228›Full record

SynthesisActa neurochirurgica2025

Burr hole evacuation of chronic subdural hematoma in general versus local anesthesia: a systematic review and meta-analysis.

Clara F Weber, Kiarash Ferdowssian, Nils Hecht, Peter Vajkoczy, Lars Wessels, Robert Mertens

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Clara F WeberDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Kiarash FerdowssianDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Nils HechtDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Peter VajkoczyDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. peter.vajkoczy@charite.de.
Lars WesselsDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Robert MertensDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeChronic subdural hematoma (cSDH) is a highly prevalent condition that frequently requires surgical evacuation. This is typically achieved through burr hole evacuation, which can be performed under either local anesthesia (LA) or general anesthesia (GA). In the present study, we provide a systematic review and meta-analysis to study and compare the safety and efficacy of cSDH evacuation in LA and GA.

methodsFollowing the PRISMA guidelines, we screened four databases for studies that compared postoperative outcomes after burr hole evacuation of cSDH in LA versus GA. Baseline characteristics and postoperative outcome data were collected, and risk ratios were calculated for each study as well as pooled across records. Random effect models were applied to continuous data points. Bias was assessed using the MINORS tool.

resultsWe identified 22 eligible studies covering 3917 patients in total. LA was associated with decreased risk for complications (p < 0.001), shorter surgery duration (p < 0.001) and hospital stay (p < 0.001). There was no statistically significant association with recurrence rates, postoperative seizure or occurrence of pneumocephalus. In a subanalysis including only data from studies utilizing subdural drainage, results remained largely similar with LA proving advantageous in terms of shorter surgery duration (p < 0.001) and hospital stay (p < 0.001).

conclusionLA may serve as a safe alternative to GA for cSDH surgery, associated with fewer postoperative complications and providing benefits regarding shorter hospital stay and surgery duration.

Indexed as

Anesthesia, GeneralAnesthesia, LocalHematoma, Subdural, ChronicTrephiningHumansPostoperative ComplicationsTreatment OutcomeBurr hole evacuationChronic subdural hematomaGeneral anesthesiaLocal anesthesiaSystematic review

Identifiers

PMID40056228
PMCPMC11890363

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.