• Ho Seong Cho, Hyun-Seok Lee, Yoo Sung Jeon, Won Hee Lee, and Kyung Rae Cho.
• Department of Neurosurgery, Konkuk University Medical Center, Neungdong-Ro, Gwangjin-Gu, Seoul, Republic of Korea.
• Eur J Trauma Emerg Surg. 2024 Jul 1.

BackgroundChronic Subdural Hemorrhage(cSDH) is often treated with surgical blood drainage, but concerns about recurrence and outcomes persist. Surgical techniques, including irrigation, vary. This study compares the outcomes of irrigation in cSDH surgery.Materials And MethodsFrom September 2020 to September 2022, 92 cSDH patients underwent surgery. Two different irrigation methods were used: extensive irrigation (IG) and non-irrigation (NIG). Method of irrigation was selected by each surgeon's preference. Parameters measured included volume of hematoma changes, midline shifting, complications, and basic demographics. Recurrence was defined as symptomatic or hematoma expansion more than double the volume before surgery. Factors predicting recurrence and irrigation method impact were analyzed.ResultsEleven patients were excluded because of bilateral or related to other disease. We analyzed 81 patients (44 NIG, 37 IG). Recurrence occurred in 6 IG cases (16.2%) and 1 NIG case (2.3%). Irrigation method significantly affected recurrence (P = 0.043). Age, gender, medication, medical history, and preoperative measurements had no major impact on recurrence. NIG had unexpected cases of intracerebral hemorrhage.ConclusionExtensive irrigation may increase recurrence in cSDH drainage. Non-irrigation drainage had fewer recurrences, but unexpected complications arose. Careful drainage in non-irrigated cases is crucial.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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