• Muhammad Shaheer Akhtar, Zahid Khan, Muhammad Kashif, Waheed Alam, Haider Ali, and Irfan Ali.
• Department of Neurosurgery, Lady Reading Hospital, Peshawar, Pakistan.
• J Coll Physicians Surg Pak. 2023 Apr 1; 33 (4): 460464460-464.

ObjectiveTo evaluate the efficacy and complications of subgaleal drain placement after two burr-holes evacuation of chronic subdural hematoma (CSDH).Study DesignDescriptive study.Place And Duration Of StudyThe Neurosurgical unit of the Lady Reading Hospital, Peshawar, from April to November 2021.MethodologySixty-four consecutive patients diagnosed with surgically significant unilateral chronic subdural hematoma were prospectively included after obtaining informed consent. All the patients underwent two burr-holes craniectomies and evacuation, followed by subgaleal drain placement. Patient demographics, pre- and postoperative clinical information including hematoma resolution and complications were collected.ResultsThis study included 44 (69%) males and 20 (31%) females with a mean age of 70.1 ± 8 years. The most common presenting symptoms were headaches (70%) and confusion (68%). Eighteen patients (28%) were taking warfarin or other anticoagulants, whereas, 23 patients (36%) were taking antiplatelet medications at the time of presentation. Thirty-six (56.3%) patients had a history of head trauma. Warfarin use was statistically significant in the patients with no history of head injury. Fifty-five patients (85%) showed no significant recurrence on the 2 week postoperative computed tomography (CT) scan. None of the patients had intraparenchymal hematoma or contusion of iatrogenic origin on postoperative CT scans.ConclusionSubgaleal drain placement after two burr-holes craniectomy led to high-resolution rates. However, no parenchymal injuries were attributed to the procedure.Key WordsChronic subdural hematoma, Subdural drain, Subperiosteal drain, Burr-hole craniostomy.

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