[Clinical analysis of bone flap craniotomy for 17 patients with chronic subdural hematomas].

OBJECTIVE: To deepen the understanding of chronic subdural hematoma and to seek the effective treatment for chronic subdural hematoma (CSDH).

METHODS: We retrospectively reviewed a series of 17 consecutive patients with CSDH, who received the treatment of bone flap craniotomy. To explore the surgical indications for CSDH, the data of imaging appearance, intraoperative findings and postoperative complications were analyzed.

RESULTS: Among the patients, 13 were septated CSDH, with the characteristic imaging features such as anti-"3" impression in the inner edge of the hematoma and fibrous strap structure in the hematoma. Four patients were organized CSDH, with strong signals of T1 and T2 as well as hypointense netlike structure within the hematoma cavity while low signal on MRI in the thickened inner membrane. Burr hole trepanation was performed, but no improvement were achieved, whereas the bone flap craniotomy removed the hematoma completely without serious surgical complication except 1 case.

CONCLUSION: Based on the preoperative imaging data, flap bone craniotomy seems to be the first choice for treatment of CSDH.