Comparison of One Versus Two Burr Hole Procedures in Evacuation of Chronic Subdural Hematoma

ABSTRACT Objective: To compare the two techniques of chronic subdural hematoma evacuation, i.e. one burr hole versus two burr holes, in terms of recurrence and duration of hospital admission. Study Design: Quasi-experimental study Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital Rawalpindi Pakistan, from Aug to Dec 2019. Methodology: Two hundred twenty-eight patients with chronic subdural hematoma were recruited for this study and equally distributed into two groups. In the One-Burr Hole Group, all patients were operated by a single burr hole drilled via a pneumatic burr in the parietal bone on the affected side. In contrast, in the Two-Burr Hole Group, all patients were subjected to two burr holes, with one burr hole made in the parietal bone and the second burr hole in the frontal bone on the affected side. Results: Patients 14(12.28%) with two burr hole procedures significantly (p=0.001) recurred less than patients 27(23.68%) who were subjected to One Burr Hole treatment. The mean hospital stay (days) for Two-Hole Burr Group (Mean=9.00± 2.00) was significantly less than One-Hole Burr Group (Mean=14.00±3.00). However, operation time (minutes) on average for patients that were subject to Two-Hole Burr (Mean=110.00±7.00) procedure was significantly (p-0.001) longer than One-Hole Burr (Mean= 96.00 ±6.00) patients. Conclusion: It is better to evacuate the chronic subdural hematoma using a two burr holes procedure as the rate of recurrence, and the hospital stay are less as compared to the single burr hole technique.