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.

中文翻译：

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开颅术与内镜辅助钻孔引流术治疗孤立性慢性硬膜下血肿 (ICSH) 的治疗效果：一项单中心长期回顾性比较研究。

背景孤立性慢性硬膜下血肿（ICSH）作为一种特殊的稀有物种，其治疗存在很大争议。进行了一项回顾性分析，以比较 ICSH 的开颅术与内窥镜辅助钻孔引流术 (EATD)。方法回顾性收集和分析2011年1月至2019年4月ICSH开颅手术或EATD患者资料。在 106 名患者中，49 名和 57 名患者分别接受了开颅手术和 EATD 治疗。复发率、发病率和死亡率是主要结果。结果两组均无复发。EATD 组的发病率 (2/57, 3.5%) 显着低于开颅手术组 (17/49, 34.7%, p = 0.0033)。EATD组无死亡病例，开颅组3例死于手术产物。开颅组平均手术时间（95.3min）明显长于EATD组（66.5min，P=0.0032）。开颅组术中失血量（213.2ml）多于EATD组（34.5ml，P=0.0044）。EATD 患者住院时间更短，恢复更快。结论与开颅手术相比，EATD是治疗ICSH更有效、更安全的方法。