subperiosteal-drain-insertion-anchorage-after-single-burr-hole

Subperiosteal Drain Insertion and Anchorage after Single Burr Hole Evacuation of Chronic Subdural Hematoma

Symptomatic chronic subdural hematoma is treated by surgical evacuation followed by drain insertion for post-operative drainage. There is no international ...

ABO dependent variation in von Willebrand factor (vWF) and factor VIII have an impact on hemostasis. Several contradictory studies have investigated the influence of ABO blood type in surgical hemorrhage. Emergency surgery is associated with an increased risk of perioperative hemorrhage leading to inferior clinical outcomes. The aim of this study was to investigate if patients with blood type O received more transfusions with blood components compared with non-O patients after major emergency abdominal surgery.

The impact of blood type on transfusion after major emergency abdominal surgery.

Perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) is known to reduce inflammatory response in relation to surgery. Inflammation may promote recurrence of cancer, thus inhibition by use of NSAIDs could reduce recurrence after surgery.

Perioperative Use of Nonsteroidal Anti-inflammatory Drugs Decreases the Risk of Recurrence of Cancer After Colorectal Resection: A Cohort Study Based on Prospective Data.

Major emergency abdominal surgery is associated with excess mortality. Transfusion is known to be associated with increased morbidity and emergency surgery is an independent risk factor for perioperative transfusion. The primary objectives of this study were to identify risk factors for transfusion, and secondarily to investigate the influence of transfusion on clinical outcomes after major emergency abdominal surgery.

Blood transfusion in major emergency abdominal surgery.

In most neurosurgical centers, irrigation is an essential part of the surgical procedure for chronic subdural hematoma (CSDH). However, it is unknown whether the volume of irrigation fluid affects the risk of CSDH recurrence. This study aimed to investigate a potential association between the volume of irrigation fluid used during burr hole evacuation of CSDH and the risk of CSDH recurrence.

Intraoperative Irrigation and Risk of Chronic Subdural Hematoma Recurrence.

Lordosis Distribution Index (LDI) is a new radiographic parameter associated with postoperative residual symptoms in patients undergoing Transforaminal Lumbar Interbody Fusion (TLIF). Recently, it has been applied on patients undergoing instrumented spine surgery, however not correlated to Patient Related Outcome Measures (PROMs). This study investigates whether the obtained the postoperative LDI after TLIF surgery correlates with the clinical outcome measured with PROMs.

Postoperative lordosis distribution index, patient reported outcome measures, and revision surgery following transforaminal lumbar interbody fusion.

Insertion of an external ventricular drain (EVD) is a first-line treatment of acute hydrocephalus caused by aneurysmal subarachnoid haemorrhage (aSAH). Once the patient is clinically stable, the EVD is either removed or replaced by a permanent internal shunt. The optimal strategy for cessation of the EVD is unknown. Prompt closure carries a risk of acute hydrocephalus or redundant shunt implantations, whereas gradual weaning may increase the risk of EVD-related infections.

Prompt closure versus gradual weaning of external ventricular drain for hydrocephalus following aneurysmal subarachnoid haemorrhage: a statistical analysis plan for the DRAIN randomised clinical trial.

This study aimed to investigate the immunologic profile of chronic subdural hematoma (CSDH) subtypes based on their radiologic appearances, with a focus on comparing the membranous CSDH to other subtypes.

Immunoprofile of Radiologic Chronic Subdural Hematoma Subtypes.

Antithrombotic Therapy After Burr Hole Evacuation of Chronic Subdural Hematoma: A Post Hoc Analysis of 2 Randomized Clinical Trials.

Passive subdural drainage is used to reduce the risk of chronic subdural hematoma (cSDH) recurrence and mortality. However, the effects of patient positioning on intracranial pressure (ICP) during passive drainage remain unclear.

Intracranial pressure changes during early postoperative mobilization in patients with chronic subdural hematoma.

[Not Available].

Chronic subdural hematoma (CSDH) frequently recurs after burr-hole craniostomy with drainage. The role of intraoperative irrigation-whether to irrigate at all, and the optimal fluid, temperature, and volume-remains uncertain. We aimed to synthesise contemporary comparative evidence. MEDLINE, Embase, and Scopus were searched to 14 October 2024; ClinicalTrials.gov and grey literature (conference abstracts, theses/dissertations) were also searched. Screening and risk-of-bias assessment were performed in duplicate. The primary outcome was reoperation for recurrence; mortality and overall complications were secondary outcomes. Random-effects meta-analyses pooled two prespecified comparisons: irrigation versus no irrigation and artificial cerebrospinal fluid (aCSF) versus saline. Heterogeneity (I²/τ²) and small-study effects (Egger's test where k ≥ 10) were examined, with fixed-effects models as sensitivity analyses. Irrigation temperature and volume were summarised narratively because of heterogeneous protocols. Fifty-six studies were included. Across 29 comparisons (n = 4,042), irrigation did not clearly reduce reoperation versus no irrigation (RR 0.89, 95% CI 0.70-1.14; I² = 25%; low-certainty evidence). Mortality and complications were similar (moderate-certainty evidence). A large multicentre non‑inferiority RCT failed to demonstrate that omitting irrigation lay within the prespecified margin (7.5%); its point estimate favoured irrigation. Among studies using irrigation, warmed fluid (~ 37 °C) was associated with lower recurrence than room-temperature irrigation (~ 22 °C; 6% vs. 14%), without safety concerns (moderate-certainty evidence). For fluid composition, pooled estimates suggested a possible advantage of aCSF over saline (random-effects RR 0.60, 95% CI 0.35-1.03; I² = 58%; low-certainty evidence), but results included a neutral multicentre RCT. Irrigation volume showed no adjusted association with recurrence. Intraoperative irrigation during burr-hole craniostomy of CSDH offers no confirmed overall reduction in recurrence, complications, or mortality, but warmed (~ 37 °C) irrigation appears beneficial and carries minimal risk. Evidence for the influence of irrigation fluid type and volume remains uncertain and low in certainty. Registration: PROSPERO CRD42024595146.

Irrigation practices in surgical evacuation of chronic subdural hematoma: systematic review and meta-analysis of technique, fluid type, and temperature.

Letter to the Editor Re: Moghib K, Ahmed MT, Ghanm TIE, et al. Optimal duration of postoperative drainage following burr-hole surgery for chronic subdural hematoma: a systematic review and network meta-analysis. Langenbeck's archives of Surgery. 2025;410:278. doi:10.1007/s00423-025-03853-y.

Article	Year
The impact of blood type on transfusion after major emergency abdominal surgery. Transfusion\| PubMed ID: 30537035	2019
Perioperative Use of Nonsteroidal Anti-inflammatory Drugs Decreases the Risk of Recurrence of Cancer After Colorectal Resection: A Cohort Study Based on Prospective Data. Annals of surgical oncology\| PubMed ID: 31313040	2019
Blood transfusion in major emergency abdominal surgery. European journal of trauma and emergency surgery : official publication of the European Trauma Society\| PubMed ID: 33388785	2022
Intraoperative Irrigation and Risk of Chronic Subdural Hematoma Recurrence. Operative neurosurgery (Hagerstown, Md.)\| PubMed ID: 37819102	2024
Postoperative lordosis distribution index, patient reported outcome measures, and revision surgery following transforaminal lumbar interbody fusion. World neurosurgery: X\| PubMed ID: 38173686	2024
Prompt closure versus gradual weaning of external ventricular drain for hydrocephalus following aneurysmal subarachnoid haemorrhage: a statistical analysis plan for the DRAIN randomised clin... Trials\| PubMed ID: 39010208	2024
Immunoprofile of Radiologic Chronic Subdural Hematoma Subtypes. World neurosurgery\| PubMed ID: 39461416	2025
Antithrombotic Therapy After Burr Hole Evacuation of Chronic Subdural Hematoma: A Post Hoc Analysis of 2 Randomized Clinical Trials. JAMA neurology\| PubMed ID: 40455427	2025
Intracranial pressure changes during early postoperative mobilization in patients with chronic subdural hematoma. Acta neurochirurgica\| PubMed ID: 40888964	2025
[Not Available]. Ugeskrift for laeger\| PubMed ID: 40916389	2025
Irrigation practices in surgical evacuation of chronic subdural hematoma: systematic review and meta-analysis of technique, fluid type, and temperature. Neurosurgical review\| PubMed ID: 41217544	2025
Letter to the Editor Re: Moghib K, Ahmed MT, Ghanm TIE, et al. Optimal duration of postoperative drainage following burr-hole surgery for chronic subdural hematoma: a systematic review and n... Langenbeck's archives of surgery\| PubMed ID: 41436665	2025

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