title: [Management of chronic subdural hematoma with twist-drill craniostomy. Report of 213 patients].
abstract: OBJECTIVE
  Controversies 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.
  
  
  METHODS
  Two 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Twist-drill craniostomy is a less time consuming, safe, effective, and cost-efficient method for the treatment of chronic subdural hematoma.
authors.affiliation: Servicio de Neurocirugía de los hospitales Teodoro Maldonado Carbo, Guayaquil, Ecuador. robertosantos@porta.net
authors.forename: Roberto Antonio
authors.initials: RA
authors.lastname: Santos-Ditto
authors.forename: Jorge Arturo
authors.initials: JA
authors.lastname: Santos-Franco
authors.forename: Mario Wilfrido
authors.initials: MW
authors.lastname: Pinos-Gavilanes
authors.forename: Henín
authors.initials: H
authors.lastname: Mora-Benítez
authors.forename: Tatiana
authors.initials: T
authors.lastname: Saavedra
authors.forename: Víctor
authors.initials: V
authors.lastname: Martínez-Gonzáles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000379:methods; D004322:Drainage; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies