Once the symptoms of intracranial hypertension appear, surgical treatment is needed, and the first choice is drilling and drainage. Therefore, even if the patient is old, we should try our best to treat him, and even have a bedside craniotomy. As long as the treatment is timely, he can often turn the corner. The problem is that the recurrence rate of hematoma after operation is still 3.7% ~ 38%.

1. Drilling or cone hole flushing drainage

According to the location and size of hematoma, choose two holes (one high and one low). Because the effect of single-hole drilling irrigation and drainage is basically the same as that of double-hole drilling irrigation and drainage, many clinicians use single-hole drilling irrigation and drainage.

2. Subdural puncture of lateral horn of anterior fontanel

Children with chronic subdural hematoma and patent anterior fontanel can be treated by subdural puncture and hematocele aspiration through the anterior fontanel. If it is a bilateral hematoma, it should be punctured alternately from left to right, and the extracted blood will gradually fade and the hematoma volume will also decrease. If blood is drawn and/or the hematoma does not shrink, incision should be used instead.

3. Craniotomy with bone flap for chronic subdural hematoma.

It is suitable for patients with chronic subdural hematoma with thick capsule or calcification.