Universität zu Köln

Baschera, Dominik ORCID: 0000-0002-9634-9922, Tosic, Lazar, Westermann, Leonard, Oberle, Joachim and Alfieri, Alex ORCID: 0000-0002-0209-4114 (2018). Treatment Standards for Chronic Subdural Hematoma: Results from a Survey in Austrian, German, mid Swiss Neurosurgical Units. World Neurosurg., 116. S. E983 - 13. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

BACKGROUND: Although an abundance of literature about the treatment of chronic subdural hematoma is available, it provides little evidence to clarify which treatment is most successful. OBJECTIVE: The aim of this study was to examine and compare current clinical standards between several hospitals. METHODS: Chairmen of all neurosurgical units in Austria, Germany, and Switzerland, as listed on the national neurosurgical societies' websites, were invited to participate with a personal token to access a web-based survey. A total of 159 invitations were sent and up to 5 reminder e-mails. RESULTS: Eighty-four invitees (53%) completed the survey. The most common surgical intervention was a single burr hole in 52 (65%) of the responding neurosurgical units, double burr holes were performed as primary procedure in 16 centers (20%h a small osteoplastic craniotomy in 4 (5%), and a twist drill craniostomy in 8 (10%). Seventy-two (90%) would place a drain in estimated 75%-100% of cases or whenever possible/safe. Sixty-five used subdural-external drains, and 7 used subgaleal-external drains. Seventeen applied suction to the drains. Thirty-six (49%) agreed with the statement that watchful waiting was an option for the treatment of chronic subdural hematomas and 19 (23.4%) disagreed. Eighteen (23%) would consider corticosteroids and 34 (45%) tranexamic acid as part of their armamentarium for the treatment of subdural hematomas. CONCLUSIONS: The results of this survey reflect the current evidence available in literature. Although the benefits of using of a drain are widely recognized, no consensus regarding the type of drain and surgical approach to the hematoma was reached.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Baschera, Dominik UNSPECIFIED orcid.org/0000-0002-9634-9922 UNSPECIFIED Tosic, Lazar UNSPECIFIED UNSPECIFIED UNSPECIFIED Westermann, Leonard UNSPECIFIED UNSPECIFIED UNSPECIFIED Oberle, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Alfieri, Alex UNSPECIFIED orcid.org/0000-0002-0209-4114 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-178881
DOI:	10.1016/j.wneu.2018.05.145
Journal or Publication Title:	World Neurosurg.
Volume:	116
Page Range:	S. E983 - 13
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BURR-HOLE EVACUATION; POSTOPERATIVE RECURRENCE; SUBPERIOSTEAL DRAINAGE; INTERNATIONAL SURVEY; QUESTIONNAIRE SURVEY; SURGICAL-PROCEDURES; RANDOMIZED-TRIAL; MANAGEMENT; IRRIGATION; PLACEMENT Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17888