• Roberto Antonio Santos-Ditto, Jorge Arturo Santos-Franco, Mario Wilfrido Pinos-Gavilanes, Henín Mora-Benítez, Tatiana Saavedra, and Víctor Martínez-Gonzáles.
• Servicio de Neurocirugía de los hospitales Teodoro Maldonado Carbo, Guayaquil, Ecuador. robertosantos@porta.net
• Gac Med Mex. 2007 May 1;143(3):203-8.

ObjectivesControversies regarding the surgical management of chronic subdural hematoma still remain. The objective of the present study was to describe our experience with twist-drill craniostomy.Patients And MethodsTwo hundred and thirteen patients were treated at the "Teodoro Maldonado Carbo" and "Alcívar" facilities between January 1992- February 2005. The surgical technique consisted of a twist-drill made under local anesthesia at the patient's bedside. We administered the Markwalder grading scale and the Glasgow outcome scale to assess treatment results. Clinical outcome, complications and relapse were measured.ResultsThe etiology was traumatic in 65% of cases. At admission, 79% scored 2 of the Markwalder grading scale. Nine percent of the patients displayed complications. The chronic subdural hematoma persisted in 8%; they were treated again with another twist-drill craniostomy with favorable results. At six months, 97.6% reached 5 in the Glasgow outcome scale.ConclusionsTwist-drill craniostomy is a less time consuming, safe, effective, and cost-efficient method for the treatment of chronic subdural hematoma.

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