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

Jaiswal, Somil; Chaudhuri, Anup K.; Ghosh, Sudipto; Saha, Supratim; Jaiswal, Pooja

doi:10.1515/romneu-2017-0057

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Age, gender, and clinical status at admission are important determinants of clinical outcome after surgery. [14] In our study, the mean age in BHC and TDC groups were 61.39 ± 13.21 SD and 73.36 ± 10.82 SD, respectively. There were 76.19% male and 23.81% female in BHC group.…”

Section: Discussionmentioning

confidence: 45%

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Comparative study of single burr-hole craniostomy versus twist-drill craniostomy in patients with chronic subdural hematoma

2019

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Background: Chronic subdural hematoma (CSDH) is predominantly a disease of the elderly. On accounting its risk-to-benefit ratio, there was always controversy regarding the management of the CSDH as to which procedure is superior. Aims: The aim is to compare the clinical and radiological outcomes in patients of CSDH who have undergone single burr-hole craniostomy (BHC) versus twist-drill craniostomy (TDC). Patients and Methods: A retrospective study was conducted in patients admitted with CSDH who had undergone single BHC or TDC between January 2014 and December 2016. Patients between 18 and 90 years of age were selected. Patients with CSDH showing computed tomography (CT) scan findings of homogeneous hypodensity, homogeneous isodensity, and mixed density were selected. CT scan findings of CSDH with hyperdense gravity-dependent fluid level were also selected. Patients with CT evidence of multiple septations were excluded from the study. Recurrent CSDH, bilateral CSDH, and CSDH with secondary acute bleed were also excluded. Diagnosis was done using noncontrast CT scan. The maximum thickness of the CSDH was measured in the axial film of CT scan. The presence of midline shift (MLS) was measured as any deviation of the septum pellucidum from the midline in axial CT film. The mass effect was determined by the effacement of the sulci, sylvian fissure obscuration, or compression of lateral ventricles. The decrease in the signs and symptoms in postoperative period was considered as the postoperative clinical improvement. Improvement in the postoperative CT scan was determined by the decrease in the thickness of CSDH and absence of the MLS with decrease in the mass effect. The presence of the CSDH with mass effect and MLS was considered as the significant residue in the postoperative CT scan. Patients with significant residue underwent reoperation. Results: There were 63 patients in BHC group and 46 patients in TDC group. The mean age in BHC and TDC groups was 61.39 ± 13.21 standard deviation (SD) and 73.36 ± 10.82 SD, respectively. There were 48 (76.19%) male and 15 (23.81%) female in BHC group. There were 32 (69.57%) male and 14 (30.43%) female in TDC group. In BHC group, 41.27% were on the right side and 58.73% on the left side. In TDC group, 50% were on the right side and 50% on the left side. In BHC group, 82.54% were in the frontotemporoparietal region, 9.52% in the frontoparietal region, 6.35% in the temporoparietal region and 1.58% in the parietooccipital region. In TDC group, 86.95% were in the frontotemporoparietal region, 8.69% in the frontoparietal region, 2.17% in the temporoparietal region, and 2.17% in the parietooccipital region. There was no significant difference in duration of symptoms and history of trauma in both the groups. The symptoms of the patients in BHC versus TDC include weakness of the limbs (44.44% vs. 73.91%), headache (50.79% vs. 32.60%), altered sensorium or decreased memory (44.44% vs....

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Section: Discussionmentioning

confidence: 45%

“…Age, gender, and clinical status at admission are important determinants of clinical outcome after surgery. [14]…”

Section: Discussionmentioning

confidence: 99%

Comparative study of single burr-hole craniostomy versus twist-drill craniostomy in patients with chronic subdural hematoma

2019

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“…Seizure is also one of the surgical complications of evacuation of cSDH in our study it occurred in 2 patient (9.4%) and this is higher than the results of Jaiswal et al in a study on 41 patients underwent evacuation of cSDH using TDC which had no cases of postoperative seizures. while in the work of Rohde V et al on 376 patients operated using BHC (13.6%) exhibited postoperative seizures [24] [26].…”

Section: Seizuresmentioning

confidence: 99%

Twist Drill Evacuation of Chronic Subdural Hematoma in Comorbid Patients

Abdel-Hamid¹,

Nouby²,

Al-Ghani³

et al. 2019

OJMN

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Chronic Subdural Hematoma (CSDH) is one of the most common types of intracranial hemorrhage, and the prognosis is good if treated properly. The standard treatment for CSDH is surgical evacuation. Various surgical procedures are used such as burr holes evacuation, twist-drill craniostomy, and craniotomy. Our aim is to evaluate the feasibility and safety of twist dill as a first-choice treatment in evacuation of CSDH in comorbid patients. Methods: This study is a prospective analysis of CSDH evacuation using two twist drill craniostomy holes and irrigation conducted on 21 patients with different comorbidities in Assuit University Hospital between May 2017 and May 2018. Results: The overall postoperative clinical improvement was 95.2%. The operative time was less than 10 minutes in 71.4% of the patients. 4 patients showed residual collection in the post-operative CT (19%). Pneumocephaly was detected in 2 patients (9.5%). Postoperative seizures occurred in 2 patients (9.5%), and subarachnoid hemorrhage was detected in one patient (4.7%). Conclusion: This approach is a new modification of twist drill craniostomy which can decrease the postoperative residual and recurrence rates and also still a minimally invasive and lifesaving technique in patients with different comorbidities.

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“…[3][4] It is more frequent in the elderly population, where age-related reductions in brain volume with corresponding increases in the extent of the subdural space enhance vulnerability to this condition. 5 The major risk factor linked with around two-thirds of individuals with CSDHs is a history of head trauma, which is usually a minor trauma. [5][6] Some of the cases might be the result of a problematic coagulation system or those using antiplatelet medicines.…”

Section: Introductionmentioning

confidence: 99%

“…5 The major risk factor linked with around two-thirds of individuals with CSDHs is a history of head trauma, which is usually a minor trauma. [5][6] Some of the cases might be the result of a problematic coagulation system or those using antiplatelet medicines. The most prevalent CSDHs are seen on the most curved frontal or occipital convexity of brain tissue.…”

Section: Introductionmentioning

confidence: 99%

Comparison of One vs. Two Burr Hole Craniostomy in Chronic Subdural Hematoma Recurrence

Khan

Ahmad

et al. 2022

Pak J Neurol Surg

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Introduction/Objective: Chronic subdural hematoma (CSDH) is most frequent neurosurgical conditions. To find the recurrence rate of chronic subdural hematoma in patients who underwent one vs. two burr craniostomy. Material And Methods: A randomized controlled trial was conducted at the Neurosurgery department, Ayub Teaching Hospital, Abbottabad. In the current study, a total of 76 (38 in each group) patients were observed. ASA-I, ASA-II, ASA III patients, symptomatic radiologically proven Chronic subdural hematoma. Patients were randomly allocated into two groups of 38 patients each. randomization with blocks. Group A was treated with intraoperative epidural methylprednisolone while Group B was treated with normal saline only. Clinical information was recorded on a pre-designed proforma. Results: Mean age was 54 years in group A, and 56 years in group B. In group A, 74% were male and 26% of patients were female. In Group B, 76% were male and 24% were female. The group A, 5% of patients had recurrence while in Group B, 13% of patients had a recurrence. There existed a significant difference between effectiveness and not-effectiveness of one/two burr hole craniostomy among patients who were less than 40 years. Conclusion: The recurrence rate of chronic subdural hematoma is higher in patients undergoing two burr hole craniostomy as compared to one burr craniostomy.

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

Cited by 4 publications

References 16 publications

Comparative study of single burr-hole craniostomy versus twist-drill craniostomy in patients with chronic subdural hematoma

Comparative study of single burr-hole craniostomy versus twist-drill craniostomy in patients with chronic subdural hematoma

Twist Drill Evacuation of Chronic Subdural Hematoma in Comorbid Patients

Comparison of One vs. Two Burr Hole Craniostomy in Chronic Subdural Hematoma Recurrence

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