{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T01:35:46Z","timestamp":1793842546389,"version":"4.6.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recurrence after burr-hole evacuation for chronic subdural hematoma (cSDH) remains clinically relevant, and modifiable operative details may influence early failure. We evaluated a standardized single-burr-hole aspiration\u2013irrigation with drainage (SBAID) workflow incorporating high-point burr-hole positioning (Wei's point), active aspiration\u2013irrigation, air elimination, and frontal-directed drainage, hypothesizing that improved early cavity\u2013air dynamics would translate into fewer early reoperations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective cohort study, we included consecutive adults with symptomatic, imaging-confirmed cSDH treated with single-burr-hole evacuation and closed drainage between November 2016 and December 2024. Patients underwent SBAID or conventional single-burr-hole irrigation and drainage (SBID). The primary outcome was recurrence requiring reoperation within 60 days. Secondary outcomes included operative duration, length of stay, postoperative complications, and quantitative imaging markers of early postoperative cavity\u2013air burden (48-h residual subdural space and pneumocephalus volumes, and ~30-day residual cavity volume). Multivariable logistic regression and propensity score\u2013based sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 186 patients (SBAID,\n                      <jats:italic>n<\/jats:italic>\n                      = 151; SBID,\n                      <jats:italic>n<\/jats:italic>\n                      = 35), 60-day reoperation-defined recurrence occurred in 2.6% vs. 14.3%, respectively (OR 0.16, 95% CI 0.04\u20130.64;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.013). SBAID was associated with shorter operative time and shorter time to discharge (both\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), smaller 48-h residual subdural space and pneumocephalus volumes, and smaller ~30-day residual cavity volume (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Postoperative seizures were less frequent with SBAID, whereas in-hospital mortality did not differ.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this single-center retrospective cohort, SBAID was associated with lower early reoperation-defined recurrence and reduced postoperative cavity\u2013air burden vs. conventional SBID.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1813950","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T04:23:00Z","timestamp":1779164580000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Standardized single-burr-hole aspiration\u2013irrigation with drainage is associated with lower early recurrence in chronic subdural hematoma"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhenjiang","family":"Pan","sequence":"first","affiliation":[{"name":"Yangpu District Shidong Hospital of Shanghai","place":["Shanghai, China"]},{"name":"Shidong Hospital, University of Shanghai for Science and Technology","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuxu","family":"Xu","sequence":"additional","affiliation":[{"name":"Yangpu District Shidong Hospital of Shanghai","place":["Shanghai, China"]},{"name":"Shidong Hospital, University of Shanghai for Science and Technology","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shepeng","family":"Wei","sequence":"additional","affiliation":[{"name":"Yangpu District Shidong Hospital of Shanghai","place":["Shanghai, China"]},{"name":"Shidong Hospital, University of Shanghai for Science and Technology","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2798","DOI":"10.1016\/S0140-6736(24)00686-X","article-title":"Burr-hole drainage with vs without irrigation for chronic subdural haematoma (FINISH): a randomised clinical trial","volume":"403","author":"Raj","year":"2024","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1890","DOI":"10.1056\/NEJMoa2313472","article-title":"Adjunctive middle meningeal artery embolization for subdural hematoma","volume":"391","author":"Davies","year":"2024","journal-title":"N Engl J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1056\/NEJMoa2409845","article-title":"Embolization of the middle meningeal artery for chronic subdural hematoma (STEM)","volume":"392","author":"Fiorella","year":"2025","journal-title":"N Engl J Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1056\/NEJMoa2401201","article-title":"Middle meningeal artery embolization for nonacute subdural hematoma","volume":"391","author":"Liu","year":"2024","journal-title":"N Engl J Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00068-025-02939-y","article-title":"Postoperative pneumocephalus is associated with recurrence rates in chronic subdural hematoma","volume":"51","author":"Alenezi","year":"2025","journal-title":"Eur J Trauma Emerg Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"STROBE initiative. 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