[Chronic subdural hematoma: a review of the literature. Part 2]

Abstract

The second part of this review is concerned with methods and results of treatment in chronic subdural hematoma (CSDH). Surgical evacuation is the generally accepted approach to treatment in CSDH. There are two neurosurgical methods of evacuation: 1. Burr hole in the cranial vault and evacuation of hematoma fluid. 2. Craniotomy and removal of hematoma with surrounding membranes. According to the literature, priority should be given to burr hole evacuation of the hematoma on the following premises: 1. High effectiveness with lower risk of complications and better treatment outcome for trepanation. 2. Craniotomy with removal of hematoma membranes, although radical, does not eliminate the risk of recurrence of hematoma. 3. Reduction in the volume of hematoma fluid through the burr hole and drainage may lead to total resorption of hematoma together with membranes.