Abstract：
OBJECTIVE: To describe a simple variation of burr hole craniostomy for the management of chronic subdural hematoma (CSDH) that uses a frontal drainage system to facilitate timely decompression in the event of tension pneumocephalus and spares the need for additional surgery.
METHODS: We conducted a retrospective analysis of 20 patients with CSDH who underwent burr hole craniostomy and 20 patients who underwent the same procedure alongside the placement of a 5 Fr neonatal feeding tube as a backup drainage for the anterior craniostomy. Depending on the situation, the secondary drain stayed for a maximum of 72 hours to be opened and used in emergency settings for drainage, aspiration, or as a 1-way valve with a water seal.
RESULTS: The outcomes of 20 patients who underwent this procedure and 20 controls are described. One patient from each group presented tension pneumocephalus. One was promptly resolved by opening the backup drain under a water seal to evacuate pneumocephalus and the other patient had to undergo a reopening of the craniostomy.
CONCLUSIONS: The described variation of burr hole craniostomy represents a low-cost and easy-to-implement technique that can be used for emergency decompression of tension pneumocephalus. It also has the potential to reduce reoperation rates and CSDH recurrence. Prospective controlled research is needed to validate this approach further.
METHODS: We conducted a retrospective analysis of 20 patients with CSDH who underwent burr hole craniostomy and 20 patients who underwent the same procedure alongside the placement of a 5 Fr neonatal feeding tube as a backup drainage for the anterior craniostomy. Depending on the situation, the secondary drain stayed for a maximum of 72 hours to be opened and used in emergency settings for drainage, aspiration, or as a 1-way valve with a water seal.
RESULTS: The outcomes of 20 patients who underwent this procedure and 20 controls are described. One patient from each group presented tension pneumocephalus. One was promptly resolved by opening the backup drain under a water seal to evacuate pneumocephalus and the other patient had to undergo a reopening of the craniostomy.
CONCLUSIONS: The described variation of burr hole craniostomy represents a low-cost and easy-to-implement technique that can be used for emergency decompression of tension pneumocephalus. It also has the potential to reduce reoperation rates and CSDH recurrence. Prospective controlled research is needed to validate this approach further.
摘要：
目的：描述一种治疗慢性硬膜下血肿（CSDH）的毛刺孔颅骨造口术的简单变化，该方法使用额叶引流系统，以便在发生张力性气颅时及时减压，并且不需要额外的手术。
方法：我们对20例CSDH患者进行了头孔开颅造口术，以及20例患者进行了相同的手术，同时放置了5fr新生儿饲管作为前颅造口术的备用引流。视情况而定,二级排水沟最长可保持72小时，以便打开并在紧急排水环境中使用，抽吸,或者作为带有水封的单向阀。
结果：描述了20例接受该手术的患者和20例对照的结果。每组均有一名患者出现张力性气颅。一个患者通过在水封下打开备用排水管以排空气颅而迅速解决，另一个患者不得不重新打开颅骨造口术。
结论：所描述的毛刺孔颅造口术的变化代表了一种低成本且易于实施的技术，可用于张力性气颅的紧急减压。它还具有降低再手术率和CSDH复发的潜力。需要前瞻性对照研究来进一步验证这种方法。
方法：我们对20例CSDH患者进行了头孔开颅造口术，以及20例患者进行了相同的手术，同时放置了5fr新生儿饲管作为前颅造口术的备用引流。视情况而定,二级排水沟最长可保持72小时，以便打开并在紧急排水环境中使用，抽吸,或者作为带有水封的单向阀。
结果：描述了20例接受该手术的患者和20例对照的结果。每组均有一名患者出现张力性气颅。一个患者通过在水封下打开备用排水管以排空气颅而迅速解决，另一个患者不得不重新打开颅骨造口术。
结论：所描述的毛刺孔颅造口术的变化代表了一种低成本且易于实施的技术，可用于张力性气颅的紧急减压。它还具有降低再手术率和CSDH复发的潜力。需要前瞻性对照研究来进一步验证这种方法。
