ArticleInternational journal of applied & basic medical research
Predictors of Neurological Outcome and Recurrence after Standardized Double Burr-hole Evacuation for Chronic Subdural Hematoma.
Article in International journal of applied & basic medical research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chronic subdural hematoma (CSDH) is increasingly common in older adults. Although burr-hole evacuation is effective, outcome and recurrence remain variable. This study evaluated the predictors of outcome and recurrence after a uniform double burr-hole technique. Materials and Methods: In this prospective observational study, 101 symptomatic CSDH patients admitted to Dayanand Medical College and Hospital, Ludhiana (July 2023-September 2024) underwent double burr-hole craniostomy with subdural drain. Demographic variables, comorbidities, antithrombotic use, alcohol intake, clinical status (Glasgow Coma Scale [GCS], Markwalder grade, and modified Rankin scale mRS), CT findings (density, thickness, midline shift, laterality, membranes, and cerebral atrophy), laboratory parameters (international normalized ratio [INR], serum albumin, and total proteins), intraoperative findings, complications, recurrence, and hospital stay were recorded. Outcomes were assessed using the Glasgow Outcome Scale (GOS) at discharge and at 2 months and dichotomized as favorable (GOS 5) or unfavorable (GOS 1-4). Results: The cohort was predominantly male (81.2%) and elderly. Favorable outcome was achieved in 78.2% at discharge and 84.2% at 2 months; recurrence occurred in 14.9%. Unfavorable discharge outcome was significantly associated with older age ( Conclusion: After uniform double burr-hole evacuation, outcome and recurrence in CSDH are primarily influenced by baseline neurological status, vascular comorbidity, cerebral atrophy, membrane formation, and coagulation/nutritional markers, with antithrombotics and alcohol strongly increasing recurrence risk.
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