• G R Williams, M K Baskaya, J Menendez, R Polin, B Willis, and A Nanda.
• Department of Neurosurgery, University Health Sciences Center, Louisiana State University, 1501 Kings Highway, Shreveport, LA 71130-3932, USA.
• J Clin Neurosci. 2001 Nov 1;8(6):551-4.

BackgroundMost neurosurgeons remove clinically symptomatic subdural haematomata, but the techniques they choose remain controversial.MethodThe results from sixty-two patients diagnosed with chronic subdural haematoma were evaluated for technique, postoperative computerized tomography (CT) scan results, and complications.ResultsEleven patients had haematomata evacuated using twist-drill plus drain, 37 patients had haematomata evacuated with burr-hole only, and 14 patients were evacuated with burr-hole plus drain. Of the patients who underwent twist-drill and closed system drainage (CSD), 43% had smaller lesions on CT follow-up scans, as compared with 74% of those who underwent the burr-hole only procedure, and 65% with burr-holes with drains. Clinical outcome results showed that 64% of twist-drill and CSD patients deteriorated as compared with 16% of those with burr-hole only and 7% with burr-holes and CSDs. Sixty-four per cent of twist-drill patients required repeat evacuations as compared with 11% of those with burr-holes only, and 7% with burr-holes plus drains.ConclusionThe results at our institution indicate that burr-hole evacuation for chronic subdural haematoma is superior to twist-drill evacuation with respect to clinical outcomes and complications.Copyright 2001 Harcourt Publishers Ltd.

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