2024 American Academy of Neurology Abstract Website

Ibrahim Serag¹, Ahmed Aljabali², Aya Mohammed Sharkawy³, Belal Jaradat⁴, Nada Mostafa Al-dardery⁵, Mariam Abdelhady⁶, Mohamed Abouzid⁷, Ahmed Negida⁸
¹Faculty of medicine mansoura University, ²Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, ³Faculty of Medicine, South Valley University,, ⁴Faculty of Medicine, The Hashemite University, ⁵Faculty of Medicine, Fayoum University,, ⁶Faculty of Medicine, October 6 University, ⁷Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, ⁸Virginia Commonwealth University

Objective:

We aimed to investigate the effect of drainage versus no drainage on the rates of recurrence and mortality, as well as the clinical outcomes of cSDH.

Background:

Chronic subdural hematoma (cSDH) is a common neurosurgical condition that can cause severe morbidity and mortality. cSDH recurs after surgical evacuation in 5-30% of patients, but drains may help reduce this risk.

Design/Methods:

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched four electronic databases (PubMed, Cochrane Library, Scopus, and Web of Science) to identify eligible studies reported up to June 2022. Using Review Manager software, we reported four primary outcomes as odds ratios (ORs) and confidence intervals (CIs).

Results:

The meta-analysis included a total of 10 studies with 1961 patients. The use of drainage was found to be significantly more effective than non-drainage in reducing the "mortality rate" (OR=0.65, 95% CI 0.43 to 0.97; P=0.04), the "recurrence rate" (OR=0.39, 95%CI 0.28 to 0.55; P<0.00001) and occurrence of "gross focal neurological deficit" (OR= 0.58, 95% CI 0.37 to 0.89; P=0.01). No significant difference was found in the occurrence of a Glasgow Coma Scale score of 15 (OR= 1.21, 95% CI 0.84 to 1.76; P=0.30).

Conclusions:

The use of drains after burr-hole irrigation reduces the recurrence, mortality, and gross focal neurological deficit rates of chronic subdural hematomas.