Chronic Subdural Hematoma Treated By Two Burr-Hole Craniostomy and Closed- System Drainage in Elderly Patients

4 Objective: This is a retrospective study of a series of 45 patients older than 60s years with chronic subdural hematoma treated by two burr-hole craniostomy and closed drainage. Methods: Case records were evaluated for etiology, preoperative, postoperative and early followup neurological status, Karnofsky performance score, computerized tomography (CT) scan results, and complications. Results: The series included 32 males and 13 females, with a mean age of 76,3 years. The principal symptom was altered mental status, gait disturbance, and headache. 11 patients had no known etiological factors. Karnofsky performance score was 64,89 preoperatively, and 70,67 postoperatively. The mean thickness of the hematoma was 2,14 cm preoperatively, and 0,9 cm postoperatively. 6 patients died in hospital due to systemic complications. A second operation was performed in 8 cases. Conclusion: Two burr-hole craniostomy and closed drainage system is a simple, safe and efficient method for the treatment of CSDHs. In this series, the worst prognostic factors were the preoperative neurological status and additional systemic diseases at the time of surgery.