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Bedside twist drill craniostomy for chronic subdural hematoma: a comparative study.
Eric M Horn1, Iman Feiz-Erfan, Ruth E Bristol
1Division of Neurological Surgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
Surgical Neurology
|January 24, 2006
Summary
Bedside twist drill craniostomy is an effective treatment for chronic subdural hematomas, comparable to standard surgical methods. This minimally invasive procedure offers similar outcomes and can be considered a primary treatment option.
Area of Science:
- Neurosurgery
- Minimally Invasive Procedures
Background:
- Chronic subdural hematomas (CSDH) require effective drainage.
- Standard treatments include bur hole or craniotomy.
- Efficacy of bedside twist drill craniostomy (TDC) for CSDH is not well-established compared to standard methods.
Purpose of the Study:
- To compare the efficacy of TDC with standard bur hole or craniotomy for CSDH.
- To evaluate clinical success, recurrence, hospitalization, complications, and neurologic outcomes.
Main Methods:
- Prospective nonrandomized trial comparing TDC with bur hole/craniotomy.
- Inclusion criteria: CT-confirmed CSDH with symptoms requiring drainage.
- Outcomes assessed: clinical success, recurrence, length of hospitalization, complications, neurologic outcome.
Main Results:
- 79 patients with 91 CSDHs treated (55 TDC, 24 bur hole/craniotomy).
- No significant differences in age, hematoma thickness, hospitalization, reoperation, mortality, or discharge disposition.
- Neurologic outcomes were similar between groups.
Conclusions:
- Bedside TDC is as effective as operative bur hole or craniotomy for CSDH.
- TDC can be considered a first-line treatment for symptomatic CSDH.