SynthesisNeurosurgical review2025
Unilateral or bilateral drainage for patients with bilateral chronic subdural hematoma: a systematic review and retrospective cohort study.
Synthesis in Neurosurgical review, 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.
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.
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.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative outcomes of unilateral and bilateral drainage in bilateral chronic subdural hematoma: A systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Incidence and predictors of contralateral surgery after initial unilateral evacuation of bilateral chronic subdural hematomas: A population-based cohort study.Brain & spine · 2026Article
- Role of the postoperative subdural space and midline shift in predicting chronic subdural hematoma recurrence: A single-center study.Surgical neurology international · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bilateral chronic subdural hematoma (cSDH) can be treated with unilateral or bilateral drainage. Unilateral drainage reduces surgery-related risks but could entail growth of the contralateral, non-operated hematoma. This study aims to (1) determine the incidence of additional contralateral surgery, (2) find factors associated with its occurrence, and (3) evaluate outcomes of uni- and bilateral drainage in bilateral cSDH patients. A systematic review (SR) conducted according to the PRISMA guidelines, pooled incidences of additional contralateral surgery with 95% confidence intervals (CI). Meta-analyses explored factors associated with contralateral surgery. Subsequently, a single-center, retrospective cohort study of bilateral cSDH patients treated with burr hole craniostomy (2010-2022) was performed. The primary outcome was occurrence of additional, contralateral surgery after unilateral drainage. Additionally, surgical complications, 30-day mortality, and reoperation rates (ipsilateral recurrence and additional contralateral surgery) were compared for unilateral and bilateral approaches in all patients and in two subgroups: cases with clinical equipoise regarding surgical approach and a propensity score-matched cohort. The pooled incidence of additional contralateral surgery in 697 patients (SR: 630, cohort: 67) receiving unilateral surgery was 14% (95% CI: 9-19%). Smaller ipsilateral hematoma (mean difference (MD): 12.2 ml, 95% CI: 7.18-17.23) and larger contralateral hematoma (MD: -25.4 ml, 95% CI: -43.95/-6.85) were independently associated with contralateral treatment (meta-analysis SR). Among 178 patients of the retrospective cohort, bilateral drainage had higher complication rates (9.9% vs. 1.5%, p = 0.032). In 93 patients with clinical equipoise and in 56 propensity score-matched patients, surgical approach did not affect reoperation, complications, or 30-day mortality rate. In patients with bilateral cSDH, additional contralateral treatment is required in 14% of all patients. Bilateral surgery carried higher complication risks in our cohort, but in the two subgroups, unilateral or bilateral approaches yielded similar outcomes. Prospective studies are required to further define in which patients unilateral surgery may suffice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.