Turkish Neurosurgery 2012 , Vol 22 , Num 2
Results of Single Burr Hole Drainage for Acute Subdural Hematoma with Non-Reactive Pupil
Youichi YANAGAWA1, Toshihisa SAKAMOTO2
1Juntendo University, Emergency and Disaster Medicine, Bunkyo-ku, Japan
2National Defense Medical College, Critical Care Medicine and Traumatology, Saitama, Japan
DOI : 10.5137/1019-5149.JTN.5206-11.0 AIM: To investigate the effects of emergency burr hole drainage for acute subdural hematoma (ASDH) with bilateral non-reactive pupils.

MATERIAL and METHODS: A retrospective study was conducted by reviewing medical records from 1998 to 2007. Patients meeting the following criteria were included: 1) head injury with unconsciousness (Glasgow Coma Scale score 8); 2) bilateral non-reactive pupils on arrival; 3) ASDH with disappearance of basal cistern on computed tomography (CT); and 4) performance of emergency single burr hole drainage. Subjects were divided into survival and non-survival groups.

RESULTS: Pupil size on the small side was significantly smaller in the survival group than in the non-survival group. All pupils on the small side in the survival group were 4 mm.

CONCLUSION: Emergency burr hole drainage should still be considered in patients with ASDH showing bilateral non-reactive pupils and one pupil 4 mm. Keywords : Acute subdural hematoma, Single burr hole drainage, Pupil, Herniation, Surgical outcome

Corresponding author : Youichi Yanagawa, yyanaga@juntendo.ac.jp