Document Detail

Modified twist drill technique in the management of chronic subdural hematoma.
MedLine Citation:
PMID:  23344867     Owner:  NLM     Status:  MEDLINE    
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.
Yad Ram Yadav; Sharda Yadav; Vijay Singh Parihar
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Turkish neurosurgery     Volume:  23     ISSN:  1019-5149     ISO Abbreviation:  Turk Neurosurg     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-24     Completed Date:  2013-07-09     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  9423821     Medline TA:  Turk Neurosurg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  50-4     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Craniotomy / instrumentation*,  methods*
Drainage / instrumentation,  methods
Enteral Nutrition*
Equipment Design
Hematoma, Subdural, Chronic / surgery*
Middle Aged
Prospective Studies
Skull / surgery
Surgical Procedures, Minimally Invasive / instrumentation,  methods
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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