AccScience Publishing / EJMO / Online First / DOI: 10.36922/ejmo.8532
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ORIGINAL RESEARCH ARTICLE

Reduction of cortical injury using a subdural catheter guidance device: A comparative study on burr hole drainage for chronic subdural hematoma

Pasut Limchoopornwikul1 ,  Chunxia Wang2 ,  Yibo Han1,3 ,  Ganlin Li1 ,  Shengda Xiao1 ,  Zhiwei Wu4 ,  Zhipeng Li1 ,  Yibao Wang1 ,  Yong Wang1*
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1 Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
2 Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, Liaoning Province, China
3 Department of Organ and Tissue Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
4 Department of Neurosurgery, Shenyang Ninth People’s Hospital, Shenyang, Liaoning Province, China
EJMO, 8532 https://doi.org/10.36922/ejmo.8532
Received: 14 January 2025 | Revised: 4 March 2025 | Accepted: 10 March 2025 | Published online: 26 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Chronic subdural hematoma (CSDH) is a chronic hemorrhagic lesion caused by the accumulation of blood between the arachnoid mater and the dura mater. Currently, the most commonly used surgical approach for CSDH is burr hole craniotomy. However, this procedure employs a blind technique, making the cerebral cortex susceptible to injury. The use of a subdural catheter guidance device combined with burr hole drainage in the treatment of CSDH can prevent intraoperative cerebral cortex damage and reduce its potential impact. This study retrospectively analyzed a total of 518 patients with CSDH who underwent surgical treatment at the hospital. Of these, 361 were male (69.69%) and 157 were female (30.31%), with a median age of 59.5 years (range: 12 – 92 years). All patients underwent preoperative head computed tomography and/or magnetic resonance imaging scans, which revealed crescent-shaped mixed-density or iso-dense shadows beneath the inner table of the skull. Informed consent for the burr hole decompression procedure was obtained from all patients. Subsequently, the 518 patients were randomly divided into two groups: The control group (undergoing the procedure without a “guidance device”) and the experimental group (undergoing the procedure with a “guidance device”). All patients provided consent for the publication of their clinical details and related images. In the control group, 274 patients with CSDH were treated, among whom 6 cases had post-operative cortical injury complications, with an incidence rate of 2.19%. In the experimental group, 244 patients with CSDH were treated, and no cortical injury complications occurred post-operatively, with an incidence rate of 0. Fisher’s exact test (two-tailed) showed p=0.0427, indicating a significant reduction in cortical injury complications with the use of the guidance device. In addition, the conditional maximum-likelihood estimate (CMLE) odds ratio for Fisher’s exact test was 0, with a 95% confidence interval ranging from 0.0 to 0.9447, further reflecting the relationship between the relevant factors. This indicates that incorporating a subdural catheter guidance device during burr hole drainage for CSDH can assist surgeons in avoiding damage to the cerebral cortex.

Keywords
Chronic subdural hematoma
One burr-hole craniotomy
Subdural catheterization guidance device
Cortex damage
Drainage tubes
Funding
None.
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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