Evaluation of One Burr Hole Evacuation for Subdural Hematoma

Study Overview
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Brief Summary
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To evaluate the outcome of one burrhole evacuation for subdural hematoma and it has the same result of traditional two burrhole

Detailed Description
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Subdural hematoma (SDH): abnormal Collection of Liquefied blood degradation underneath the dura matter (1.2.3). one of the most frequent types of intracranial haemorrhage, That is still associated with significant morbidity (1.4.5). The SDH: is a common disease in elderly Patient, and Its Incidence is highest in persons older than 70 Years of age (1.5). Types of Subdural hematoma(18.19) 1- Acute: present within 48-72 hours of injury. 2. Sub-acute: manifest itself between 3-20 day. 3- Chronic (CH): produce symptoms from 3 weeks to several months after injury Risk Factors: (7.8.9.10.11.12) Trauma; mostly minor Trauma, Approximately two thirds of The Patients have suffered one. Reports exist of chronic SDH due to birth trauma in neonates. Advanced age: The elderly are at risk due to: brain atrophy, whereby The bridging veins are stretched and become more fragile. Older People tend to fall more often and Suffer minor head trauma. With increase age, The incidence of blood Thinner administration raises leading to increased risk for haemorrhage Chronic alcoholism: Gender: men, from all age groups, suffer higher rates of chsDH than woman. CoagulaPathy: Therapeutic anticoagulation and antiplatelet therapy. Medical Conditions: sepsis, hepatic failure, hemophilia, DIC and renal dialysis. Intracranial hypotension: as after ventriculoperitoneal shunt. clinical presentation (1.13) Symptoms of increase intra cranial pressure: Headache, Nausea, vomiting. Focal neurological deficit - (weakness, aphasia). Disturbed conscious level (DCL) Seizures Imaging investigation: CT brain (14.15) Management : (1.6.16.17) Conservative: A watch, wait and re-scan Policy is usually recommended in asymptomatic or minimally symptomatic patient with a thin CHSDH. Surgical: For symptomatic (SDH) a- burr hole drainage B-twist drill drainage c- craniotomy prognostic factors : (2.5) 1- age of patient 2- Associated chronic diseases like hypertension, liver diseases …….Etc 3- Laboratory investigation like Hb , platlate count ,pc,and PT. 5- Hematoma thickness 6- number of burr hole : one or two burr hole

Official Title
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Evaluation of One Burr Hole Evacuation for Subdural Hematoma

Conditions
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Subdural Hematoma

Intervention / Treatment
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* Procedure: Evacuation for subdural hematoma by one burrhole


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with subdural hematoma either unilateral or bilateral fit for surgery Chronic SDH Subacute SDH Age: patients older than 18 years old SEX: Both sex Exclusion Criteria: Patients unfit for surgery Acute SDH subdural hyroma subdural empyema patient treated conservatively

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Evacuation for subdural hematoma by one burrhole|Evacuation for subdural hematoma by one burrhole|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ClinicalEvaluation of evacuation for subdural hematoma by one burrhole | glasgo coma scale, neurological deficit, clinical symptoms (seizures) . | 72 hours post operative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Radiological evaluation for outcome | Nearly gross total evacuation according to confirmation by postoperative CT brain | 72 hours post operative |