The goal of this randomized controlled trial is to evaluate whether the adjuvant application of non-thermal plasma (NTP) during standard surgical drainage of chronic subdural hematoma (cSDH) can reduce the recurrence rate at 6 months. The main questions it aims to answer are:
* Does NTP application significantly lower the radiological and clinical recurrence rate of cSDH compared to surgery alone?
* Is NTP safe when applied to the subdural space and surgical wound bed?
* Does NTP improve functional outcomes and time to hematoma resolution?
Participants will be randomly assigned to one of two groups:
* Experimental group (n = 20): Standard burr hole drainage or craniotomy plus intraoperative NTP application over the exposed dura mater, the residual membrane, soft tissue layers, and the skin incision.
* Control group (n = 20): Standard surgical drainage alone (no NTP).
Follow-up includes clinical assessments and computed tomography (CT) scans at 1 week, 3 months, and 6 months post-surgery. The primary outcome is recurrence (symptomatic reaccumulation requiring re-intervention or ≥50% volume increase on CT).