Bedside twist drill craniostomy for chronic subdural hematoma: a comparative study

Horn, Eric M.; Feiz-Erfan, Iman; Bristol, Ruth E.; Spetzler, Robert F.; Harrington, Timothy

doi:10.1016/j.surneu.2005.05.030

Cited by 94 publications

(87 citation statements)

References 17 publications

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“…Smely et al (17) has reported 50% cases related to trauma. The two groups in other studies of Horn et al (19) and Muzii et al (20) are similar. Other Predisposing factors in both the groups in my study were similar without any significant difference.…”

Section: Predictors Of Outcomesupporting

confidence: 76%

“…Horn et al (19) has reported 7% and 13%, Gokmen et al (21) 2.6% and 3% whereas Muzii et al (20) has reported no significant difference in two groups. In our study mortality in TDC group was 2.44 % (1 case) and in BHC group was 2.78% (1 case).…”

Section: Predictors Of Outcomementioning

confidence: 93%

“…Burr hole craniostomy has the best cure to complication ratio and is superior to twist drill craniostomy in the treatment of recurrences (19).…”

Section: Introductionmentioning

confidence: 99%

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Twist drill craniostomy vs Burr hole craniostomy in chronic subdural hematoma: a randomized study

Jaiswal¹,

Chaudhuri²,

Ghosh³

et al. 2017

Romanian Neurosurgery

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Aim: To compare two most common operative procedures used in patients with chronic subdural hematomas -Twist drill craniostomy and Burr Hole Craniostomy. Material and Methods:The study was a prospective randomized controlled trial on patients with chronic subdural hematomas. Results: Both procedures are comparable with respect to outcome but surgical duration is statistically higher in Burr Hole craniostomy than Twist Drill Craniostomy. Conclusion: Twist Drill Craniostomy is procedure of choice in emergency surgical situation.

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Section: Predictors Of Outcomesupporting

confidence: 76%

Section: Predictors Of Outcomementioning

confidence: 93%

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Twist drill craniostomy vs Burr hole craniostomy in chronic subdural hematoma: a randomized study

Jaiswal¹,

Chaudhuri²,

Ghosh³

et al. 2017

Romanian Neurosurgery

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“…Twist drill craniostomy (TDC) can be performed at the bedside (2). It also carries the risk of complications due to the blind technique.…”

Section: Introductionmentioning

confidence: 99%

Modified twist drill technique in the management of chronic sub dural hematoma.

Yadav

Yadav²,

Parihar³

2012

Turkish Neurosurgery

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AIm: Burr-hole craniostomy is the most efficient and safe choice for surgical drainage of chronic subdural hematoma (CSDH). Although the twist-drill drainage is also relatively safe and time-saving, it carries the risk of inadequate drainage, brain penetration and hematoma formation. Our modified technique helps in avoiding bleeding and brain penetration. mAterIAl and methOds:The preferred sites for twist drill were the most curved parts on the cranium. Normal drilling at about 90 degree angle was done on the most curved surfaces while it was at about 60 degree angles on flat surface. This angled drilling and the curved guide wire (hooked in the distal blind end of infant feeding tube), helped to guide infant feeding tube in the hematoma cavity. Dura matter was coagulated using insulated wire.results: There was no procedure related hematoma, brain penetration and mortality in any of the 50 patients managed by the modified technique. Infant feeding tube was properly positioned in all the cases. Burr hole evacuation was done in 7 cases (14%) due to inadequate evacuation of the hematoma after TDC.COnClusIOn: Our modified technique of twist drill drainage is inexpensive, simple, safe and effective alternative technique in the treatment of CSDH.KeywOrds: Chronic subdural hematoma, Intracranial subdural hematoma, Subdural hematoma, Minimally invasive technique, Operative surgical procedure ÖZ AmAÇ: Burr-hole kraniyostomi kronik subdural hematomun (CSDH) cerrahi drenajı için en etkin ve güvenli tercihtir. Helezon matkap drenajı nispeten güvenli olsa ve zaman tasarrufu yapsa da yetersiz drenaj, beyin penetrasyonu ve hematom oluşması risklerini taşır. Modifiye tekniğimiz kanama ve beyin penetrasyonundan kaçınmaya yardımcı olur. yÖntem ve GereÇler: Helezon matkap için tercih edilen yerler kraniyumun en kıvrımlı kısımlarıydı. En kıvrımlı yüzeylerde yaklaşık 90 derece açıyla normal matkapla delme işlemi yapılırken düz yüzeyde açı yaklaşık 60 dereceydi. Bu açılı matkapla delme ve eğri kılavuz tel (infant besleme tüpünün distal kör ucuna kanca şeklinde takılmış), infant besleme tüpünü hematom kavitesine yönlendirmeye yardımcı oldu. Dura mater yalıtımlı telle koagüle edildi.BulGulAr: Modifiye teknikle takip edilen 50 hastanın hiçbirinde işlemle ilgili hematom, beyin penetrasyonu ve mortalite görülmedi. İnfant besleme tüpü tüm durumlarda uygun şekilde konumlanmıştı. TDC sonrasında hematomun yetersiz boşaltılması nedeniyle 7 vakada (%14) burr-hole ile boşaltma yapıldı. sOnuÇ: Modifiye helezon matkap drenajı tekniğimiz CSDH tedavisinde ucuz, basit, güvenli ve etkin bir alternatif tekniktir.AnAhtAr sÖZCÜKler: Kronik subdural hematom, İntrakraniyel subdural hematom, Subdural hematom, Minimal invaziv teknik, Cerrahi işlem

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“…2,14,26 The effectiveness of various surgical techniques (including bur hole craniostomy alone, bur holes with subdural drains, bedside twist drill craniostomy with drain placement, and formal craniotomy) have been extensively evaluated. 5,6,10,15,20,21,31,33 Variations of each of these techniques have also been studied, including the duration of subdural drainage, 32 location of the subdural catheter after bur hole drainage, 22 the number of bur holes, 24 bur holes with passive subperiosteal drainage system, 33 and the position of the head after bur hole placement 1 or twist-drill treatment.…”

Section: Discussionmentioning

confidence: 99%

Minicraniotomy versus bur holes for evacuation of chronic subdural collections in infants—a preliminary single-institution experience

Klimo

Matthews

Lew

et al. 2011

PED

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Object Various surgical interventions have been described to evacuate chronic subdural collections (CSCs) of infancy. These include transfontanel percutaneous aspiration, subdural drains, placement of bur hole(s) with or without a subdural drain, and shunting. Shunt placement typically provides good long-term success (resolution of the subdural fluid), but comes with well-known early and late complications. Recently, the authors have used a mini–osteoplastic craniotomy technique with the goal of definitively treating these children with a single surgery while avoiding the many issues associated with a shunt. They describe their procedure and compare it with the traditional bur hole technique. Methods In this single-institution retrospective study, the authors evaluated 26 cases involving patients who underwent treatment for CSC. Preoperative, intraoperative, and postoperative data were reviewed, including radiographic findings (density of the subdural fluid and ventricular and subarachnoid space size), neurological examination findings, and intraoperative fluid description. The primary outcome was treatment failure, defined as the patient requiring any subsequent surgical intervention after the index procedure (minicraniotomy or bur hole placement). Results Fifteen patients (10 male and 5 female; median age 5.1 months) collectively underwent 27 minicraniotomy procedures (each procedure representing a hemisphere that was treated). In the bur hole group, there were 11 patients (6 male and 5 female; median age 4.6 months) with 18 hemispheres treated. Both groups had subdural drains placed. The average follow-up for each treatment group was just over 7 months. Treatment failure occurred in 2 patients (13%) in the minicraniotomy group compared with 5 patients (45%) in the bur hole group (p = 0.09). Furthermore, the 2 patients who had treatment failure in the minicraniotomy group required 1 subsequent surgery each, whereas the 5 in the bur hole group needed a total of 9 subsequent surgeries. Eventually, 80% of the patients in the minicraniotomy group and 70% of those in the bur hole group had resolution of the subdural collections on the last imaging study. Conclusions The minicraniotomy technique may be a superior technique for the treatment of CSCs in infants compared with bur hole evacuation. The minicraniotomy provides greater visualization of the subdural space and allows more aggressive evacuation of the fluid, better irrigation of the space, the ability to fenestrate any accessible membranes safely, and continued egress of fluid into the subgaleal space. Although this preliminary report has obvious limitations, evaluation of this technique may be worthy of a prospective, multiinstitutional collaborative effort.

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Bedside twist drill craniostomy for chronic subdural hematoma: a comparative study

Cited by 94 publications

References 17 publications

Twist drill craniostomy vs Burr hole craniostomy in chronic subdural hematoma: a randomized study

Twist drill craniostomy vs Burr hole craniostomy in chronic subdural hematoma: a randomized study

Modified twist drill technique in the management of chronic sub dural hematoma.

Minicraniotomy versus bur holes for evacuation of chronic subdural collections in infants—a preliminary single-institution experience

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