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The goal of this clinical trial is to compare the outcome of double burr hole versus single burr hole in patients of chronic subdural hematoma undergoing subdural drain evacuation.
The main questions it aims to answers are
1. Which one of the surgical method i.e single burr hole or double burr hole is clinically superior with better post operative prognosis for the drainage of chronic subdural hematoma.
2 Compare the post operative complications in both the techniques in term of wound infection hospital stay duration , recurrence and mortality.
participants will be divided in two groups one group will be treated with single burr hole technique second group will be treated with double burr hole technique.
After procedure, patients will be followed-up in hospital until discharge and total hospital stay will be noted. Patients will be followed-up further in OPD . During follow-up, patients will be evaluated for wound infection, recurrence and mortality.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Double burr Hole Arm | Experimental | this arm includes patient who receive double burr hole craniotomy surgical procedure for drainage of chronic subdural hematoma |
|
| Single Burr Hole Arm | Experimental | this arm includes patient who receive single burr hole craniotomy surgical procedure for drainage of chronic subdural hematoma |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Single Burr hole Craniotomy | Procedure | Single Burr hole made at the point of highest collection of hematoma in subdural space in brain. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Recurrence Of Chronic Subdural Hematoma | recurrence rate of chronic subdural hematoma evaluated if volume of sdh >15ml or significant mass effect on CT brain within 3 months post operatively | From date of surgery until radiologically confirmed recurrence (defined as subdural hematoma volume >15 mL or significant mass effect on CT brain) requiring repeat intervention, assessed up to 3 months postoperatively |
| quantity of hematoma evacuated | Intraoperatively evacuated hematoma quantity measured in millilitres and also includes the quantity obtained in subdural drain till 72 hours postoperatively | Measured intraoperatively at the time of surgery and cumulatively measured postoperatively from surgery until removal of the subdural drain, assessed up to 72 hours postoperatively. |
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Inclusion Criteria:
Exclusion Criteria:
• Patients in shock (BP≤100/60 mmHg) or history of seizures
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| Name | Affiliation | Role |
|---|---|---|
| Muhammad Hassan Tabish, MBBS | Services Hospital / Services Institute of Medical Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Services Institute of Medical Sciences / Services Hospital | Lahore | Punjab Province | 54770 | Pakistan |
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| Double Burr hole Craniotomy | Procedure | Two burr hole made in skull each at parietal eminence and around superior temporal line to drain chronic subdural hematoma |
|
| ID | Term |
|---|---|
| D020200 | Hematoma, Subdural, Chronic |
| ID | Term |
|---|---|
| D006408 | Hematoma, Subdural |
| D020198 | Intracranial Hemorrhage, Traumatic |
| D020300 | Intracranial Hemorrhages |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006406 | Hematoma |
| D006470 | Hemorrhage |
| D014947 | Wounds and Injuries |
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