A modified technique to treat subdural hematomas: the subdural evacuating port system.

BACKGROUND: The Subdural Evacuating Port System (SEPS) is intended for drainage of subdural fluid collections such as hygromas and hematomas. Unlike other subdural fluid drainage systems, no drain is placed in the subdural space. This paper describes the technique and reports our experience thus far. METHODS: We treated 20 patients for 22 subdural hematomas. One or two ports were inserted for drainage of each subdural collection. Follow-up ranged from six to 24 months. RESULTS: Follow-up CT obtained at approximately one month postprocedure showed complete or near complete resolution of 18 of the subdural collections. Failure of the SEPS was noted in four patients and was related to plugging of the drainage system by clots secondary to the presence of fresh blood in the subdural collection. CONCLUSIONS: The Subdural Evacuating Port System (SEPS) permits the neurosurgeon to drain subacute or chronic hematomas by a method which is minimally invasive, simple and safe.