Use of Ommaya CSF reservoir for refractory chronic subdural hematoma

: Ten patients with refractory chronic subdural hematoma were the subjects of this paper. All patients had severe diseases influencing the clinical course of chronic subdural hematoma, such as cerebral infarction, liver cirrhosis, thrombocytopenia, severe parkinsonism, severe heart disease, and spino-cerebellar degeneration. They were first treated in a usual manner; irrigation and drainage of the hematoma cavity. After recurrence of the hematoma, an Ommaya CSF reservoir was put into place and whenever the volume of the hematoma increased the reservoir was punctured. Postoperatively, 7 patients returned to the same conditions as they had before the onset. However, one patient died of myocardial infarction and 2 patients with parkinsonism could not maintain the condition they had before the onset of their disease, resulting in their partially dependent state. Complications were minor bleeding in one patient and an occlusion of the reservoir in another patient. By using this method reoperation was unnecessary, and the patients were able to move early in the post-operative period. This method was suitable for refractory chronic subdural hematoma with severe disease influencing its clinical course.