IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 7 Ser. 9 (July. 2019), PP 74-76 www.iosrjournals.org DOI: 10.9790/0853-1807097476 www.iosrjournals.org 74 | Page Comparative Study of Subgaleal Versus Subdural Under Water Drainage System in the Surgical Treatment of Chronic Subdural Hematoma * Mubashshir Ali 1 , Deepak Ranade 2 , Ashish Chugh 3 , Sarang Gotecha 4 , Prashant Punia 5 1 Neurosurgery Resident, Department of Neurosurgery, Dr.D.Y.Patil Medical College ,Pimpri, Pune 2,3 Professor, Department of Neurosurgery, Dr.D.Y.Patil Medical College ,Pimpri, Pune 4 Associate Professor, Department of Neurosurgery, Dr.D.Y.Patil Medical College ,Pimpri, Pune 5 Assistant Professor, Department of Neurosurgery, Dr.D.Y.Patil Medical College ,Pimpri, Pune * Corresponding Author: Mubashshir Ali Abstract: Objective: One or two burr-hole craniotomies with subgaleal or subdural drainage system and irrigation are the most common methods for surgical treatment of chronic subdural hematoma. The aim of this study is to compare the advantages or disadvantages of these techniques used for chronic subdural hematoma. Material and methods: 50 patients were treated by burr-hole subdural drainage or subgaleal drainage system with irrigation. Our patients were classified into two groups according to the operative procedure as follows: Group I, two burr-hole craniostomies with subgaleal drain and irrigation , Group II, one burr-hole craniostomy with subdural closed drainage system without irrigation . We compared both the groups for post- operative clinical and surgical outcome. Results: In our study there were significantly less number of revision surgery and pneumocepahlous in subdural under water drain as compare to subgaleal drain. Most common presenting symptom was headache and vomiting followed by altered sensorium. Conclusion: Both of the techniques have a higher cure rate . However, subdural under water drainage system is relatively safe, and technically easy. So it is applicable for aged and higher risk patients. Keywords: Chronic subdural hematoma; subdural drainage; subgaleal drainage; Under water drain. -------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 11-07-2019 Date of acceptance: 26-07-2019 --------------------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Chronic subdural hematoma is seen frequently in daily neurosurgical practice. Its incidence is about five per one lac per year in the general population but it is higher among those older aged persons 1 . Trauma is the most important risk factor for the development of chronic subdural hematoma 2,3 . The clinical picture of Chronic subdural hematoma varies widely. Most common presenting symptoms in the headache followed by vomiting and sensorimotor changes such as amnestic or concentration deficits 2 . Surgical treatment of chronic subdural hematoma in symptomatic patients is gold standard therapy. The following types of surgical treatment approaches have been used: craniotomy, twist-drill craniostomy, burr- hole drainage with placement of a subdural drain or subgaleal drainage system. In our study, we described, and compared the consequences of subgaleal drain and subdural closed drainage systems. II. Material and Method:- Prospective Comparative study was conducted in the Department of Neurosurgery, Dr. D. Y. Patil Medical College, Pune during Dec 2016 to June 2018. A total of 50 cases of Chronic Subdural Hematoma (25 cases in Each Group).Group I : comprised of patients of subdural hematoma where subgaleal drain was placed