Recent published studies including a single randomized controlled trial have evaluated the effect of placing a subdural drain with all other factors being held equal. The results of a literature search are presented in Table I, which summarizes recurrence rates, and in Table II, which summarizes overall mortality. The only available randomized controlled study was performed between November 2004 and November 2007 at Addenbrooke’s Hospital in Cambridge, UK by Santarius et al.4 All patients underwent evacuation with two burr holes and were subsequently randomized to whether a subdural drain was placed. Outcomes were determined with questionnaires obtained at 30 days and at 6 months. A few shortcomings of this study include the inability to mask treatment allocation, missing data from incomplete questionnaires and incomplete recording, and the fact that it was a single-center study. Nevertheless, this study was able to demonstrate that using drains reduced both the recurrence rate of SDH and the 6 months’ mortality rate. Furthermore, there was no difference in length of hospital stay or in overall complication rates, including infection rates.

issue art.gif