LAUSR

BACKGROUND Isolated chronic subdural hematoma (ICSH), as a special rare species, has great controversy over its treatment. A retrospective analysis was performed to compare craniotomy with endoscopic-assisted trepanation drainage (EATD) of ICSH. METHODS The data of ICSH patients for craniotomy or EATD from January 2011 to April 2019 were retrospectively collected and analysed. Of 106 patients, 49 and 57 patients received craniotomy and EATD treatment respectively. Recurrence rate, morbidity and mortality rate were the main outcome. RESULT There was no recurrence in both groups. The morbidity rate of the EATD group (2/57, 3.5%) was significantly lower than that of the craniotomy group (17/49, 34.7%, p = 0.0033). There was no death in the EATD group, but 3 cases died of operative produce in the craniotomy group. The average operation time of the craniotomy group (95.3min) was significantly longer than that of the EATD group (66.5min, P =  0.0032). Craniotomy group had more intraoperative blood loss (213.2ml) than EATD group (34.5ml, P = 0.0044). EATD patients had shorter hospital stay and recovered faster. CONCLUSIONS Compared with craniotomy, EATD is a more effective and safer method for the treatment of ICSH.