Comparing the Use of Subgaleal and Subdural Drain in Nonacute Subdural Hematomas: Does the Hematoma Age Affect the Results?

Abstract

Aim: Surgical treatment of non-acute subdural hematomas is to place a closed drainage system in the subdural area following burr-hole trepanation,but it has tendency to drain related complications. Subgaleal drain is also suggested as an alternative, but there is no consensus yet. The aim of thisstudy is to examine the effect of hematoma age and drain insertion style on surgical outcomes.Materials and Methods: The data of 79 patients were retrospectively analyzed. The patients were divided into two groups as “subdural drain”and “subgaleal drain”. Each group was further subgrouped as “chronic hematoma” and “subacute hematoma”. They were compared in terms of thecapacity of draining the hematoma and complications such as pneumocephalus, recurrence and others. The effect of hematoma age on results wasexamined.Results: It was determined that hematoma could be evacuated more effectively in the subgaleal drain group (p=0.045). It was found that insubacute hematomas, subgaleal drain resulted in more recurrence, but prevented drain-related complications. Subgaleal drain was found to beacceptable for chronic subdural hematomas.Conclusion: The use of subgaleal drain may be an option to avoid drain-related complications. However, if the hematoma is subacute, the rate ofrecurrence increases.