Paper Title
Management of Chronic Subdural Hematoma - Our Experience of Last Seven Years

Abstract
Aim – The study was done to evaluate various practical considerations in management of chronic subdural hematomas. Introduction - Chronic SDH is collection of altered blood under dura mater which is variably more than 4 – 6 weeks old. It usually occurs in presence of atrophic brain which usually occurs in chronic alcoholics and in old age. Pathogenetic factors are mild trauma with or without some form of coagulopathy. There are various management options like twist drill and drainage, burr hole with evacuation with or without placement of drain and mini craniotomy. There are specific indications for each procedure with individual variations. We operated 74 patients of chronic SDH in last 7 years and are presenting analysis of our series. Patients and methods - The study is retrospective. We included 74 patients operated in last 7 years in single unit at our institute. Patients with very poor GCS (less than 5) and children are not included in this study. Conclusion - Timely intervention in case of chronic SDH is very gratifying in view of improvement of GCS and motor deficit without much effect of the type of procedure performed. Burr hole evacuation is the procedure of choice. Placement of feeding tube in subdural space is not effective in decreasing the incidence of residual collection. But it is very helpful in management of residual collection. Keywords – Chronic Subdural Hematoma, Twist Drill Craniostomy, Burr Holes, Brain Atrophy, Subdural Drain.