{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:34:20Z","timestamp":1791261260988,"version":"4.1.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Hunan Provincial Natural Science Foundation","award":["2022JJ30520"],"award-info":[{"award-number":["2022JJ30520"]}]},{"name":"the Hunan Provincial Health Commission's National Clinical Key Specialty Major Project","award":["20230279"],"award-info":[{"award-number":["20230279"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:p>\n                    With the aging population, symptomatic chronic subdural hematoma (CSDH) is becoming increasingly prevalent in neurosurgical practice. While burr-hole drainage remains the mainstay treatment, the optimal drilling site remains controversial. This single-center, randomized controlled noninferiority trial aimed to compare frontal versus parietal burr-hole approaches in patients aged \u226518 years requiring surgical drainage for CSDH. Participants were randomized (1:1) via computer-generated allocation to frontal or parietal burr-hole groups, with blinding maintained for patients and staff except operating neurosurgeons. All patients received postoperative atorvastatin combination therapy. Primary outcomes included 6-month recurrence rates (noninferiority margin: 5.0%), with secondary outcomes assessing functional status (modified Rankin Scale [mRS] 4\u20136), mortality, and complications. From July 2020 to December 2022, 135 of 147 screened patients (92%) were enrolled (frontal:\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 67; parietal:\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 68), comprising 79% males (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 107) and 21% females (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 28). At 6-month follow-up (completed June 2023), recurrence rates were 1.5% (1\/67) in the frontal group versus 4.4% (3\/68) in the parietal group (difference: \u22122.9%; 95% confidence interval [CI]: \u22128.6 to 2.8;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.31), meeting noninferiority criteria. Functional outcomes (mRS 4\u20136: 3.0% vs. 4.4%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.66) and mortality (3.0% vs. 1.5%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.55) showed no significant intergroup differences. Notably, postoperative pneumocephalus volume was significantly lower in the frontal group (11.6\u2009\u00b1\u200914.8 mL vs. 20.7\u2009\u00b1\u200920.4 mL;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.038). Adverse event rates were comparable between groups, with pneumonia being most frequent (53.7% vs. 55.9%) and surgical complications similarly distributed (6.0% vs. 5.9%). These findings establish noninferiority of frontal burr-hole while demonstrating reduced postoperative pneumocephalus, supporting its clinical preference and warranting future superiority trials. (Trial registration: chictr.org.cn, ChiCTR2000033967).\n                  <\/jats:p>","DOI":"10.1177\/08977151251404007","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T11:46:20Z","timestamp":1764762380000},"page":"872-881","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Frontal Burr-Hole Compared with Parietal Burr-Hole in the Management of Chronic Subdural Hematoma: A Single-Center, Randomized Controlled, Noninferiority Trial"],"prefix":"10.1177","volume":"43","author":[{"given":"Ping","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengcheng","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenkun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanding","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"issue":"12","key":"e_1_3_4_2_2","first-page":"1149","article-title":"[Epidemiology of chronic subdural hematomas]","volume":"39","author":"Karibe H","year":"2011","unstructured":"Karibe H, , Kameyama M, , Kawase M, et al. 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