Markwalder T M, Seiler R W
Neurosurgery. 1985 Feb;16(2):185-8. doi: 10.1227/00006123-198502000-00010.
A consecutive series of 21 adult patients with chronic subdural hematoma was studied in respect to postoperative resolution of subdural collections and clinical improvement after burr hole evacuation without subdural drainage. This series was compared to a previously studied series of patients with chronic subdural hematoma in whom postoperative closed system drainage had been installed. Using the identical protocol for treatment and postoperative follow-up, we obtained identical results with respect to time-related neurological improvement and persistence of subdural collections in the undrained and drained series, except that the steadily progressive clinical improvement during the early postoperative phase (24 hours) in all cases of the drained series was not universal in the undrained cases. Our study suggests that, to avoid the possibility of early postoperative clinical deterioration, burr hole craniostomy and closed system drainage is advisable. We think that subdural drainage is not necessary when the installation of the drainage system seems to be technically difficult, as it may be in cases with considerable perioperative cortical expansion.
对连续21例慢性硬膜下血肿成年患者进行了研究，观察钻孔引流但不进行硬膜下引流术后硬膜下血肿的消退情况及临床改善情况。将该系列与之前研究的一组慢性硬膜下血肿患者进行比较，后者术后安装了闭式引流系统。采用相同的治疗和术后随访方案，我们在未引流组和引流组中获得了与时间相关的神经功能改善以及硬膜下血肿持续存在情况相同的结果，只是引流组所有病例术后早期（24小时）临床改善呈稳步进展，而未引流组并非普遍如此。我们的研究表明，为避免术后早期临床恶化的可能性，建议采用钻孔开颅术和闭式引流系统。我们认为，当安装引流系统在技术上似乎困难时，如在围手术期皮质有相当程度扩张的情况下，硬膜下引流并非必要。
