Postoperative intracranial haemorrhage: a review

Springer Science and Business Media LLC - Tập 34 - Trang 393-407 - 2011
Marc A. Seifman1, Phillip M. Lewis1, Jeffrey V. Rosenfeld1,2, Peter Y. K. Hwang1,2
1Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia
2Department of Surgery, Monash University, Melbourne, Australia

Tóm tắt

Postoperative haemorrhage (POH) is one of the most serious complications of any cranial neurosurgical procedure and is associated with significant morbidity and mortality. The relative paucity of work investigating this postoperative complication prompted us to undertake a review of the literature, focussing on demographic, clinical, and surgical risk factors. A literature search was undertaken using Ovid MEDLINE (1950–2009) using keywords including craniectomy, craniotomy, neurosurgery, intracranial, reoperation, repeat craniotomy, postoperative, haemorrhage, haematoma, and bleeding. The rates of POH following intracranial procedures reported in the literature vary greatly, and meaningful comparison is difficult. We defined postoperative haemorrhage as that following craniotomy, which is clinically significant and requires surgical evacuation. Risk factors include pre-existing medical comorbidities including hypertension, coagulopathies and haematological abnormalities, intraoperative hypertension and blood loss, certain lesion pathologies including tumours, chronic subdural haematomas, and deficiencies in haemostasis. We conclude by providing recommendations for clinical practice based on the literature reviewed to aid clinicians in the detection and avoidance of POH.

Tài liệu tham khảo

Abouzari M, Rashidi A, Rezaii J, Esfandiari K, Asadollahi M, Aleali H, Abollahzadeh M (2007) The role of postoperative patient posture in the recurrence of traumatic chronic subdural haematoma after burr-hole surgery. Neurosurgery 61:794–797 Agnelli G, Piovella F, Buoncristiani P, Severi P, Pini M, D’Angelo A, Beltrametti C, Damiani M, Andrioli G, Pugliese R, Iorio A, Brambilla G (1998) Enoxaparin plus compression stockings compared with compression stockings alone in the prevention of venous thromboembolism after elective neurosurgery. N Engl J Med 339:80–85 Al-Shahi Salman R (2009) Haemostatic drug therapies for acute spontaneous intracerebral haemorrhage. Cochrane Database of Systematic Reviews Art No: CD005951 Aoki N (1986) Atrophic brain at high risk in neurosurgery: report of a case complicated by postoperative intracerebral haemorrhage and tension pneumocephalus. Neurosurgery 18:502–504 Arand A, Sawaya R (1986) Intraoperative chemical haemostasis in neurosurgery. Neurosurgery 18:223–233 Barnett H, Clifford J, Llewellyn R (1977) Safety of mini-dose heparin administration for neurosurgical patients. J Neurosurg 47:27–30 Basali A, Mascha E, Kalfas I, Schubert A (2000) Relation between perioperative hypertension and intracranial hemorrhage after craniotomy. Anesthesiology 93:48–54 Boström S, Holmgren E, Jonsson O, Lindberg S, Lindström B, Winsö I, Zachrisson B (1986) Post-operative thromboembolism in neurosurgery: a study on the prophylactic effect of calf muscle stimulation plus dextran compared to low-dose heparin. Acta Neurochir 80:83–89 Browse N, Gray L, Morland M (1977) Changes in the blood fibrinolytic activity after surgery (the effect of deep vein thrombosis and malignant disease). Br J Surg 64:23–27 Bullock R, Hannemann C, Murray L, Teasdale G (1990) Recurrent haematomas following craniotomy for traumatic intracranial mass. J Neurosurg 72:9–14 Butler W, Piaggio C, Constantinou C, Niklason L, Gonzalez R, Cosgrove G, Zervas N (1998) A mobile computed tomographic scanner with intraoperative and intensive care unit applications. Neurosurgery 42:1304–1310 Cerrato D, Ariano C, Fiacchino F (1978) Deep vein thrombosis and low-dose heparin prophylaxis in neurosurgical patients. J Neurosurg 49:378–381 Chan K, Mann K, Chan T (1989) The significance of thrombocytopaenia in the development of postoperative intracranial haematoma. J Neurosurg 71:38–41 Clifton G, Grossman R, Makela M, Miner M, Handel S, Sadhu V (1980) Neurological course and correlated computerised tomography findings after severe closed head injury. J Neurosurg 52:611–624 Cohen L (1976) Clinical pharmacology and acetylsalicyclic acid. Semin Thromb Hemostas 2:146–175 Colman R, Robboy S, Minna J (1972) Disseminated intravascular coagulation (DIC): an approach. Am J Med 52:679–687 Day A, Friedman W, Sypert G, Mickle J (1982) Successful treatment of normal perfusion pressure breakthrough syndrome. Neurosurgery 11:625–630 De Girolami U, Anthony D, Frosch M (1999) The Central Nervous System. In: Cotran R, Kumar V, Collins T (eds) Robbins pathologic basis of disease, 6th edn. WB Saunders, Philadelphia, pp 1293–1357 Diaz F, Yock D, Larson D, Rockswold G (1979) Early diagnosis of delayed posttraumatic intracerebral haematomas. J Neurosurg 50:217–223 Dickinson L, Miller L, Patel C, Gupta S (1998) Enoxaparin increases the incidence of postoperative intracranial haemorrhage when initiated preoperatively for deep venous thrombosis prophylaxis in patients with brain tumours. Neurosurgery 43:1074–1079 Elgafy H, Bransford R, McGuire R, Dettori J, Fischer D (2010) Blood loss in major spine surgery: are there effective measures to decrease massive hemorrhage in major spine fusion surgery? Spine 35:S47–S56 Erol F, Topsakal C, Ozveren M, Kaplan M, Tiftikci M (2005) Irrigation vs. closed drainage in the treatment of chronic subdural hematoma. J Clin Neurosci 12:261–263 Fadul C, Wood J, Thaler H, Galicich J, Patterson R, Posner J (1988) Morbidity and mortality of craniotomy for excision of supratentorial gliomas. Neurology 38:1374–1379 Faught C, Wells P, Fergusson D, Laupacis A (1998) Adverse effects of methods for minimizing perioperative allogenic transfusion: a critical review of the literature. Transfus Med Rev 12:206–225 Flint A, Manley G, Gean A, Hemphill J, Rosenthal G (2008) Post-operative expansion of haemorrhagic contusions after unilateral decompressive hemicraniectomy in severe traumatic brain injury. J Neurotrauma 25:503–512 Fredriksson K, Norrving B, Strömblad L (1992) Emergency reversal of anticoagulation after intracerebral hemorrhage. Stroke 23:972–977 Frim D, Barker F, Poletti C, Hamilton A (1992) Postoperative low-dose heparin decreases thromboembolic complications in neurosurgical patients. Neurosurgery 30:830–833 Fukumachi A, Koizumi H, Nagaseki Y, Nukui H (1986) Postoperative extradural haematomas: computed tomographic survey of 1105 intracranial operations. Neurosurgery 19:589–593 Fukumachi A, Koizumi H, Nukui H (1985) Postoperative intracerebral haemorrhages: a survey of computed tomographic findings after 1074 intracranial operations. Surg Neurol 23:575–580 Gazzeri R, Galarza M, Neroni MAC, Refice G, Esposito S (2007) Continuous subgaleal suction drainage for the treatment of chronic subdural haematoma. Acta Neurochir 149:487–493 Gerlach R, Raabe A, Zimmermann M, Siegemund A, Seifert V (2000) Factor XIII deficiency and postoperative haemorrhage after neurosurgical procedures. Surg Neurol 54:260–266 Gerlach R, Scheuer T, Beck J, Woszczyk A, Böhm M, Seifert V, Raabe A (2003) Risk of postoperative haemorrhage after intracranial surgery after early nadroparin administration: results of a prospective study. Neurosurgery 53:1028–1035 Gerlach R, Tölle F, Raabe A, Zimmermann M, Siegemund A, Seifert V (2002) Increased risk for postoperative haemorrhage after intracranial surgery in patients with decreased factor XIII activity: implications of a prospective study. Stroke 33:1618–1623 Gosk-Bierska I, Adamiec R, Alexewicz P, Wysokinski W (2002) Coagulation in diabetic and non-diabetic claudicants. Int Angiol 21:128–133 Grant G (2007) Update on hemostasis: neurosurgery. Surgery 142:S55–S60 Gudeman S, Kishore P, Miller J, Girevendulis A, Lipper M, Becker D (1979) The genesis and significance of delayed traumatic intracerebral haematoma. Neurosurgery 5:309–313 Haines S, Maroon J, Jannetta P (1978) Supratentorial intracerebral haemorrhage following posterior fossa surgery. J Neurosurg 49:881–886 Hall W, Truwit C (2008) Intraoperative MR-guided neurosurgery. J Magn Reson Imaging 27:368–375 Harders A, Gilsbach J, Weigel K (1985) Supratentorial space occupying lesions following infratentorial surgery: early diagnosis and treatment. Acta Neurochir 74:57–60 Harker L, Slichter S (1972) The bleeding time as a screening test for evaluation of platelet function. N Engl J Med 287:155–159 Henry D, Carless P, Moxey A, O'Connell D, Stokes B and McClelland B (2007) Anti-fibrinolytic use for minimising perioperative allogenic blood transfusion. Cochrane Database of Systematic Reviews Art No: CD001886 Holcomb J (2004) Methods for improved hemorrhage control. Crit Care 8:S57–S60 Iberti T, Miller M, Abalos A, Fischer E, Post K, Benjamin E, Oropello J, Wiltshire-Clement M, Rand J (1994) Abnormal coagulation profile in brain tumour patients during surgery. Neurosurgery 34:389–395 Ito H, Yamamoto S, Komai T, Mizukoshi H (1976) Role of local hyperfibrinolysis in the etiology of chronic subdural haematoma. J Neurosurg 45:26–31 Izumihara A, Ishihara T, Iwamoto N, Yamashita K, Ito H (1999) Postoperative outcome of 37 patients with lobar intracerebral haemorrhage related to cerebral amyloid angiopathy. Stroke 30:29–33 Jelsma R, Bucy P (1967) The treatment of glioblastoma multiforme of the brain. J Neurosurg 27:388–400 Joffe S (1975) Incidence of postoperative deep vein thrombosis in neurosurgical patients. J Neurosurg 42:201–203 Johnston I, Jennett B (1973) The place of continuous intracranial pressure monitoring in neurosurgical practice. Acta Neurochir 29:53–63 Kalfas I, Little J (1988) Postoperative haemorrhage: a survey of 4992 intracranial procedures. Neurosurgery 23:343–347 Kansal R, Nadkarni T, Goel A (2010) Single versus double burr hole drainage of chronic subdural hematomas. A study of 267 cases. J Clin Neurosci 17:428–429 Kaufman H, Moake J, Olson J, Miner M, duCret R, Pruessner J, Gildenberg P (1980) Delayed and recurrent intracranial haematomas related to disseminated intravascular clotting and fibrinolysis in head injury. Neurosurgery 7:445–449 Kaye A, Brownbill D (1981) Postoperative intracranial pressure in patients operated on for cerebral aneurysms following subarachnoid haemorrhage. J Neurosurg 54:726–732 Kayser-Gatchalian M, Kayser K (1975) Thrombosis and intracranial tumours. J Neurol 209:217–224 Kenet G, Walden R, Eldad A, Martinowitz U (1999) Treatment of traumatic bleeding with recombinant factor VIIa. Lancet 354:1879 Kleindienst A, Harvey H, Mater E, Bronst J, Flack J, Herenz K, Haupt W, Schön R (2003) Early antithrombotic prophylaxis with low molecular weight heparin in neurosurgery. Acta Neurochir 145:1085–1091 Koizumi H, Fukumachi A, Nukui H (1987) Postoperative subdural fluid collections in neurosurgery. Surg Neurol 27:147–153 Kuroki T, Katsume M, Harada N, Yamazaki T, Aoki K, Yakasu N (2001) Strict closed-system drainage for treating chronic subdural haematoma. Acta Neurochir 143:1041–1044 Kwaan H (1982) Diseases of Haemostasis. In: Beal J (ed) Critical care for surgical patients. Macmillan, New York, pp 588–598 Leblanc R, Carpenter S, Stewart J, Pokrupa R (1995) Subacute enlarging cerebral haematoma from amyloid angiopathy: case report. Neurosurgery 36:403–406 Leblanc R, Preul M, Robitaille Y, Villemure J, Pokrupa R (1991) Surgical considerations in cerebral amyloid angiopathy. Neurosurgery 29:712–718 Lentschener C, Cottin P, Bouaziz H, Mercier F, Wolf M, Aljabi Y, Boyer-Neumann C, Benhamou D (1999) Reduction of blood loss and transfusion requirement by aprotinin in posterior lumbar spine fusion. Anesth Analg 89:590–597 Lethagen S, Rugarn P, Aberg M, Nilsson I (1990) Effects of desmopressin acetate (DDAVP) and dextran on hemostatic and thomboprophylactic mechanisms. Acta Chir Scand 156:597–602 Lindenbaum J, Lieber C (1969) Haematologic effects of alcohol in man in the absence of nutritional deficiency. N Engl J Med 281:333–338 Lobato R, Rivas J, Cordobes F, Alted E, Perez C, Sarabia R, Cabrera A, Diez I, Gomez P, Lamas E (1988) Acute epidural haematoma: an analysis of factors influencing the outcome of patients undergoing surgery in coma. J Neurosurg 68:48–57 Mangano D, Miao Y, Vuylsteke A, Tudor I, Juneja R, Filipescu D, Hoeft A, Fontes M, Hillel Z, Ott E, Titov T, Dietzel C, Levin J (2007) Mortality associated with aprotinin during 5 years following coronary artery bypass graft surgery. JAMA 297:471–479 Mannucci P, Levi M (2007) Prevention and treatment of major blood loss. N Engl J Med 356:2301–2311 Manucci P (1998) Hemostatic drugs. N Engl J Med 339:245–253 Mayer S, Brun N, Begtrup K, Broderick J, Davis S, Diringer M, Skolnick B, Steiner T (2005) Recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med 352:777–785 Mellergard P, Wisten O (1996) Operations and re-operations for chronic subdural haematomas during a 25-year period in a well defined population. Acta Neurochir 138:708–713 Merriman E, Bell W, Long D (1979) Surgical postoperative bleeding associated with aspirin ingestion. J Neurosurg 50:682–684 Mokri B (2001) The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology 56:1746–1748 Mondorf Y, Abu-Owaimer M, Gaab M, Oertel J (2009) Chronic subdural hematoma—craniotomy versus burr-hole trepanation. Br J Neurosurg 23:612–616 Morgan M, Johnston I, Hallinan J, Weber N (1993) Complications of surgery for arteriovenous malformations of the brain. J Neurosurg 78:176–182 Morgan M, Sundt T (1989) The case against staged operative resection of cerebral arteriovenous malformations. Neurosurgery 25:429–436 Muzii V, Bistazzoni S, Zalaffi A, Carangelo B, Mariottini A, Palma L (2005) Chronic subdural hematoma: comparison of two surgical techniques. J Neurosurg Sci 49:41–47 Nakaguchi H, Tanishima T, Yoshimasu N (2000) Relationship between drainage catheter location and postoperative recurrence of chronic subdural haematoma after burr-hole irrigation and closed-system drainage. J Neurosurg 93:791–795 Nakaguchi H, Tanishima T, Yoshimasu N (2001) Factors in the natural history of chronic subdural haematomas that influence their postoperative recurrence. J Neurosurg 95:256–262 Nakajima H, Yasui T, Kishi H, Kan M (2002) The role of postoperative patient posture in the recurrence of chronic subdural haematoma: a prospective randomised trial. Surg Neurol 58:385–387 Nurmohamed M, van Riel A, Henkens C, Koopman M, Que G, d'Azemar P, Büller H, ten Cate J, Hoek J, van der Meer J, van der Heul C, Turpie A, Haley S, Sicurella J, Gent M (1996) Low molecular weight heparin and compression stockings in the prevention of venous thromboembolism in neurosurgery. Thromb Haemost 75:233–238 O’Brien J (1968) Effects of salicylates on human platelets. Lancet 1:779–783 Palmer J, Francis J, Pickard J, Iannotti F (2003) The efficacy and safety of aprotinin for hemostasis during intracranial surgery. J Neurosurg 98:1208–1216 Palmer J, Sparrow O, Iannotti F (1994) Postoperative haematoma: a 5-year survey and identification of avoidable risk factors. Neurosurgery 35:1061–1065 Panerai R (1998) Assessment of cerebral pressure autoregulation in humans—a review of measurement methods. Physiol Meas 19:305–338 Perel P, Roberts I, Shakur H, Thinkhamrop B, Phuenpathom N and Yutthakasemsunt S (2010) Hemostatic drugs for traumatic brain injury. Cochrane Database of Systematic Reviews Art No: CD007877 Perkins J, Cap A, Weiss B, Reid T, Bolan C (2008) Massive transfusion and nonsurgical hemostatic agents. Crit Care Med 36:S325–S339 Pleym H, Stenseth R, Wahba A, Bjella L, Tromsdal A, Karevold A, Dale O (2004) Prophylactic treatment with desmopressin does not reduce postoperative bleeding after coronary surgery in patients treated with aspirin before surgery. Anesth Analg 98:578–584 Powner D, Hartwell E, Hoots W (2005) Counteracting the effects of anticoagulants and antiplatelet agents during neurosurgical emergencies. Neurosurgery 57:823–831 Pretorius M, Kaufman H (1982) Rapid onset of delayed traumatic intracerebral haematoma with diffuse intravascular coagulation and fibrinolysis. Acta Neurochir 65:103–109 Raabe A, Gerlach R, Zimmermann M, Seifert V (2001) The risk of haemorrhage associated with early postoperative heparin administration after intracranial surgery. Acta Neurochir 143:1–7 Ratnoff O (1984) Thrombosis and the hypercoagulable state. Circulation 70:III-72 Reinhard M, Roth M, Müller T, Guschlbauer B, Timmer J, Czosnyka M, Hetzel A (2004) Effect of carotid endarterectomy or stenting on impairment of dynamic cerebral autoregulation. Stroke 35:1381–1387 Richards T, Hoff J (1974) Factors affecting survival from acute subdural haematoma. Surgery 75:253–258 Rohde V, Rohde I, Thiex R, Küker W, Ince A, Gilsbach J (2001) The role of intraoperative magnetic resonance imaging for the detection of hemorrhagic complications during surgery from intracerebral lesions. An experimental approach. Surg Neurol 56:266–275 Royston D (1998) Aprotinin versus lysine analogues: the debate continues. Ann Thorac Surg 65:S9–S19 Ruff R, Posner J (1983) Incidence and treatment of peripheral venous thrombosis in patients with glioma. Ann Neurol 13:334–336 Rughani A, Holmes C, Penar P (2009) A novel association between a chronic subdural hematoma and a fibrinolytic pathway defect: case report. Neurosurgery 64:E1192 Ryback R, Desforges J (1970) Alcoholic thrombocytopaenia in three inpatient drinking alcoholics. Arch Intern Med 125:475–477 Samii M, Matthies C (1997) Management of 1000 vestibular schwannomas (acoustic neuromas): surgical management and results with an emphasis on complications and how to avoid them. Neurosurgery 40:11–23 Santarius T, Kirkpatrick P, Ganesan D, Chia H, Jalloh I, Smielewski P, Richards H, Marcus H, Parker R, Price S, Kirollos R, Pickard J, Hutchinson P (2009) Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet 374:1067–1073 Schisano G, Nina P (2005) Aprotinin and hemostasis. J Neurosurg 102:757–758 Schwartz R, Hsu L, Wong T, Kacher D, Zamani A, Black P, Alexander E, Stieg P, Moriarty T, Martin C, Kikinis R, Jolesz F (1999) Intraoperative MR inaging guidance for intracranial neurosurgery: experience with the first 200 cases. Radiology 211:477–488 Seiler R, Zurbrügg H (1986) Supratentorial intracerebral haemorrhage after posterior fossa operation. Neurosurgery 18:472–474 Sharp A (1977) Diagnosis and management of disseminated intravascular coagulation. Br Med Bull 33:25–272 Spetzler R, Martin N, Carter L, Flom R, Raudzens P, Wilkinson E (1987) Surgical management of large AVM's by staged embolization and operative excision. J Neurosurg 67:17–28 Spetzler R, Wilson C, Weinstein P, Mehdorn M, Townsend J, Telles D (1978) Normal perfusion pressure breakthrough theory. Clin Neurosurg 25:651–672 Stanisic M, Lund-Johansen M, Mahesparan R (2005) Treatment of chronic subdural haematoma by burr-hole craniostomy in adults: influence of some factors on postoperative recurrence. Acta Neurochir 147:1249–1257 Starke R, Kim G, Fernandez A, Komotar R, Hickman Z, Otten M, Ducruet A, Kellner C, Hahn D, Chwajol M, Mayer S, Connolly E (2008) Impact of a protocol for acute antifibrinolytic therapy on aneurysm rebleeding after subarachnoid hemorrhage. Stroke 39:2617–2621 Takahashi R, Sawa H, Kuroda S, Saito H, Fujita M, Fujioka Y, Fukatsu R, Nagashima K (1996) Pathologic processes leading to cerebral haemorrhage in amyloid angiopathy. Neuropathology 16:99–105 Takahashi Y, Ohkura A, Sugita Y, Sugita S, Miyagi J, Shigemori M (1995) Postoperative chronic subdural haematoma following craniotomy: four case reports. Neurol Med Chir 35:78–81 Tanikawa M, Mase M, Yamada K, Yamashita N, Matsumoto T, Banno T, Miyati T (2001) Surgical treatment of chronic subdural haematoma based on intrahaematomal membrane structure on MRI. Acta Neurochir 143:613–619 Taussky P, Fandino J, Landolt H (2008) Number of burr holes as independent predictor of postoperative recurrence in chronic subdural haematoma. Br J Neurosurg 22:279–282 Taylor W, Thomas N, Wellings J, Bells B (1995) Timing of postoperative intracranial haematoma development and implications for the best use of neurosurgical intensive care. J Neurosurg 82:48–50 Thiagarajah S (1983) Postoperative care of neurosurgical patients. Int Anesthesiol Clin 21:139–156 Touho H, Hirakawa K, Hino A, Karasawa J, Ohno Y (1986) Relationship between abnormalities of coagulation and fibrinoylsis and postoperative intracranial haemorrhage in head injury. Neurosurgery 19:523–531 Tsutsumi K, Maeda K, Iijima A, Usui M, Okada Y, Kirino T (1997) The relationship of preoperative magnetic resonance imaging findings and closed system drainage in the recurrence of chronic subdural haematoma. J Neurosurg 87:870–875 Urban M, Beckman J, Gordon M, Urquhart B, Boachie-Adjei O (2001) The efficacy of antifibrinolytics in the reduction of blood loss during complex adult reconstructive spine surgery. Spine 26:1152–1157 Vaquero J, Cabezudo J, de Sola R, Nombela L (1981) Intratumoural haemorrhage in posterior fossa tumours after ventricular drainage. J Neurosurg 54:406–408 Vassilouthis J, Anagnostaras S, Papandreou A, Dourdounas E (1999) Is postoperative haematoma an avoidable complication of intracranial surgery? Br J Neurosurg 13:154–157 Waga S, Shimizu T, Shimosaka S, Tochio H (1981) Intratumoural haemorrhage after a ventriculoperitoneal shunting procedure. Neurosurgery 9:249–252 Waga S, Shimosaka S, Sakakura M (1983) Intracerebral haemorrhage remote from the site of the initial neurosurgical procedure. Neurosurgery 13:662–665 Wilson C (1993) General considerations. In: Apuzzo M (ed) Brain surgery: complication avoidance and management. Churchill Livingstone, New York, pp 177–185 Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S (2003) Independent predictors of recurrence of chronic subdural haematoma: results of multivariate analysis performed using a logistic regression model. J Neurosurg 98:1217–1221 Young W, Kader A, Prohovnik I, Ornstein E, Fleischer L, Ostapkovich N, Jackson L, Stein B (1993) Pressure autoregulation is intact after arteriovenous malformation resection. Neurosurgery 32:491–496 Yu G, Han C, Zhang M, Zhuang H, Jiang Y (2009) Prolonged drainage reduces the recurrence of chronic subdural hematoma. Br J Neurosurg 23:606–611 Zetterling M, Ronne-Engström E (2004) High intraoperative blood loss may be a risk factor for postoperative haematoma. J Neurosurg Anesthesiol 16:151–155 Zumofen D, Regli L, Levivier M, Krayenbühl N (2009) Chronic subdural hematomas treated by burr hole trepanation and a subperiostal drainage system. Neurosurgery 64(4):1116–1121