A new experience in surgical treatment of chronic subdural hematoma

Abstract

Objective To explore the curative effect of hematoma puncture and catheter drainage combined with urokinase injection in the surgical treatment of chronic subdural hematoma. Methods A total of 86 patients with chronic subdural hematoma were treated with unilateral or bilateral, single hole or mutilhole hematoma puncture and catheter drainage. Intraoperative washing was not done, and urokinase (20 × 10³ U/time, twice one day) was injected into the cavity of hematoma after operation. The cure rate was calculated. Postoperative complications (intracranial bleeding and infection) and the recurrence rate were recorded. Results The average operation time was (0.60 ± 0.16) h. Brain tissue was restored 3 d after injection of urokinase. The average follow-up period was (4.00 ± 0.22) months. There were 85 cases being cured, and the cure rate was 98.84%. One case was recurred, and the recurrence rate was 1.16%. No patient had postoperative intracranial bleeding or infection, or needed reoperation. Conclusions Chronic subdural hematoma can be treated by hematoma puncture and catheter drainage with no intraoperative washing but urokinase injection into the cavity of hematoma after operation, which had remarkable effect and low recurrence rate.

DOI: 10.3969/j.issn.1672-6731.2018.12.006