Pu Er Shi

Chronic subdural hematoma (CSDH) is a common neurosurgical condition where fluid builds up between the brain coverings, causing brain compression and neurological problems. The best treatment method is still uncertain, and this trial aims to compare two surgical approaches to find the most effective one. Neuroendoscopy-assisted drainage allows surgeons to directly see and remove the hematoma more thoroughly compared to the conventional burr-hole drainage method, which may reduce recurrence and drainage time. The study compares neuroendoscopy-assisted hematoma drainage with traditional burr-hole drainage. Both procedures involve drilling a single burr hole at the thickest part of the hematoma as seen on CT scan. In the neuroendoscopy group, a bone flap is created and a neuroendoscope guides thorough irrigation and evacuation of the hematoma, followed by drainage for up to 48 hours. In the burr-hole group, the hematoma cavity is irrigated until clear and drainage is also maintained for up to 48 hours after surgery. Participants will be evaluated before and after surgery, with clinical symptoms and imaging confirming CSDH diagnosis. The main outcome measured is the recurrence rate of hematoma within three months after surgery. Continuous monitoring will occur until drainage ends or the tube is removed. Follow-up visits will assess neurological status and recovery over three months, ensuring safety and treatment effectiveness throughout the study period.