Abstract
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.