Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials

Objective: This systematic review and meta-analysis aimed to compare the efficacy and safety of single- and double-burr hole craniostomies (sBHC) and (dBHC) in the management of chronic subdural hematoma (cSDH). Methods: The PubMed, MEDLINE, Embase, and Cochrane CENTRAL databases were systematically...

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Main Authors: Abdulaziz M. Alghamdi, Abdulrahman Ahmad Takroni, Abdulwhab M. Alotaibi, Razan Ayed Alboqami, Orjwan Hashem Ateeq, Fares F. Alsayegh, Faisal Alotaibi
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:World Neurosurgery: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590139725000699
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author Abdulaziz M. Alghamdi
Abdulrahman Ahmad Takroni
Abdulwhab M. Alotaibi
Razan Ayed Alboqami
Orjwan Hashem Ateeq
Fares F. Alsayegh
Faisal Alotaibi
author_facet Abdulaziz M. Alghamdi
Abdulrahman Ahmad Takroni
Abdulwhab M. Alotaibi
Razan Ayed Alboqami
Orjwan Hashem Ateeq
Fares F. Alsayegh
Faisal Alotaibi
author_sort Abdulaziz M. Alghamdi
collection DOAJ
description Objective: This systematic review and meta-analysis aimed to compare the efficacy and safety of single- and double-burr hole craniostomies (sBHC) and (dBHC) in the management of chronic subdural hematoma (cSDH). Methods: The PubMed, MEDLINE, Embase, and Cochrane CENTRAL databases were systematically searched for relevant articles. The included articles were randomized controlled trials (RCTs) written in English that compared the efficacy or safety of sBHC to that of dBHC for the treatment of patients with cSDH. Results: Nine RCTs were included in this systematic review. The length of surgery was significantly shorter in the sBHC group (mean difference = −20.65, 95 % CI [-28.58, −12.72], p < 0.00001, I2 = 96 %). The mean length of surgery in sBHC was 34.9 min, compared to 55.5 min for a dBHC. There was no significant difference in the postoperative Glasgow Coma Scale (GCS) between the groups, presence of postoperative infections, presence of postoperative pneumocephalus, length of hospital stay, recurrence rates, and mortality rate. Conclusion: Both sBHC and dBHC are efficacious surgical techniques for managing cSDH. Based on this meta-analysis of RCTs, the safety and efficacy of sBHC and dBHC were comparable without statistically significant differences.
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spelling doaj-art-4c138abfefb34f5391b063e0015cb35f2025-08-20T02:47:13ZengElsevierWorld Neurosurgery: X2590-13972025-10-012810049510.1016/j.wnsx.2025.100495Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trialsAbdulaziz M. Alghamdi0Abdulrahman Ahmad Takroni1Abdulwhab M. Alotaibi2Razan Ayed Alboqami3Orjwan Hashem Ateeq4Fares F. Alsayegh5Faisal Alotaibi6College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaCollege of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi ArabiaCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaNeuroscience Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi ArabiaObjective: This systematic review and meta-analysis aimed to compare the efficacy and safety of single- and double-burr hole craniostomies (sBHC) and (dBHC) in the management of chronic subdural hematoma (cSDH). Methods: The PubMed, MEDLINE, Embase, and Cochrane CENTRAL databases were systematically searched for relevant articles. The included articles were randomized controlled trials (RCTs) written in English that compared the efficacy or safety of sBHC to that of dBHC for the treatment of patients with cSDH. Results: Nine RCTs were included in this systematic review. The length of surgery was significantly shorter in the sBHC group (mean difference = −20.65, 95 % CI [-28.58, −12.72], p < 0.00001, I2 = 96 %). The mean length of surgery in sBHC was 34.9 min, compared to 55.5 min for a dBHC. There was no significant difference in the postoperative Glasgow Coma Scale (GCS) between the groups, presence of postoperative infections, presence of postoperative pneumocephalus, length of hospital stay, recurrence rates, and mortality rate. Conclusion: Both sBHC and dBHC are efficacious surgical techniques for managing cSDH. Based on this meta-analysis of RCTs, the safety and efficacy of sBHC and dBHC were comparable without statistically significant differences.http://www.sciencedirect.com/science/article/pii/S2590139725000699Chronic subdural hematomaSingle burr hole craniostomyDouble burr holes craniostomyBurr holeCraniostomy
spellingShingle Abdulaziz M. Alghamdi
Abdulrahman Ahmad Takroni
Abdulwhab M. Alotaibi
Razan Ayed Alboqami
Orjwan Hashem Ateeq
Fares F. Alsayegh
Faisal Alotaibi
Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials
World Neurosurgery: X
Chronic subdural hematoma
Single burr hole craniostomy
Double burr holes craniostomy
Burr hole
Craniostomy
title Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials
title_full Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials
title_fullStr Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials
title_full_unstemmed Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials
title_short Single versus double burr holes craniostomy drainage for chronic subdural hematoma: A systematic review and meta-analysis of randomized clinical trials
title_sort single versus double burr holes craniostomy drainage for chronic subdural hematoma a systematic review and meta analysis of randomized clinical trials
topic Chronic subdural hematoma
Single burr hole craniostomy
Double burr holes craniostomy
Burr hole
Craniostomy
url http://www.sciencedirect.com/science/article/pii/S2590139725000699
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