title: Comparison of the Indications and Treatment Results of Burr-Hole Drainage at the Maximal Thickness Area versus Twist-Drill Craniostomy at the Pre-Coronal Point for the Evacuation of Symptomatic Chronic Subdural Hematomas.
abstract: OBJECTIVE
  To analyze the clinical data and surgical results from symptomatic chronic subdural hematoma (CSDH) patients who underwent burr-hole drainage (BHD) at the maximal thickness area and twist-drill craniostomy (TDC) at the precoronal point.
  
  
  METHODS
  We analyzed data from 65 symptomatic CSDH patients who underwent TDC at the pre-coronal point or BHD at the maximal thickness area. For TDC, we defined the pre-coronal point to be 1 cm anterior to the coronal suture at the level of the superior temporal line. TDC was performed in patients with CSDH that extended beyond the coronal suture, as confirmed by preoperative CT scans. Medical records, radiological findings, and clinical performance were reviewed and analyzed.
  
  
  RESULTS
  Of the 65 CSDH patients, 13/17 (76.4%) with BHD and 42/48 (87.5%) with TDC showed improved clinical performance and radiological findings after surgery. Catheter failure was seen in 1/48 (2.4%) cases of TDC. Five patients (29.4%) in the BHD group and four patients (8.33%) in the TDC group underwent reoperations due to remaining hematomas, and they improved with a second operation, BHD or TDC.
  
  
  CONCLUSIONS
  Both BHD at the maximal thickness area and TDC at the pre-coronal point are safe and effective drainage methods for symptomatic CSDHs with reasonable indications.
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Gi Hun
authors.initials: GH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Bum-Tae
authors.initials: BT
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Soo-Bin
authors.initials: SB
authors.lastname: Im
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Sun-Chul
authors.initials: SC
authors.lastname: Hwang
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Je Hoon
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Dong-Seong
authors.initials: DS
authors.lastname: Shin
keywords: Burr-hole; Chronic subdural hematoma; Drainage; Evacuation; Twist-drill