Role of Incentive Spirometry after Burr Hole Evacuation of Chronic Subdural Hematomas: A Randomized Controlled Trial

Chronic subdural hematomas are a common clinical condition encountered in day-to-day neurosurgical practice. Management of chronic subdural hematomas may be either surgical or conservative. Burr hole drainage is currently the most common surgery used worldwide for the treatment of chronic subdural hematomas. However, recurrence after surgical evacuation is a common problem and has been found to occur in the range of (5-30)%. A number of factors are associated with post-operative recurrence following surgical evacuation such as male gender, elderly age group, bilateral hematoma etc. Several adjuvant therapies with surgery are investigated for preventing recurrence which includes corticosteroids, atorvastatin and middle meningeal artery embolization. 3 ball incentive spirometry has been used in our institution following subdural hematoma evacuation to prevent recurrence. The main mechanism driving this idea is to increase the intracranial pressure and promote brain expansion which ultimately results in drainage of blood products.

Hence, this study is conducted to analyze the effect of incentive spirometry in preventing recurrence following burr-hole evacuation of chronic subdural hematoma.