CPT® Code 61108

Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma

A twist drill hole is a surgical procedure that involves creating an opening in the skull to facilitate the evacuation of a subdural hematoma. This procedure is performed using a specialized hand twist drill, which is designed to penetrate the skull safely. The drill is equipped with a safety stop that is adjusted to the anticipated thickness of the skull at the specific site of the procedure. As the drill is advanced, it passes through the outer and inner tables of the skull. The operator monitors for a change in resistance, which indicates that the inner table has been successfully penetrated and the dura mater, the protective membrane surrounding the brain, has been punctured. Once the dura is breached, a syringe is inserted through the newly created drill hole into the subdural space, allowing for the flushing out of the subdural hematoma, which is a collection of blood that can exert pressure on the brain and lead to serious complications if not addressed promptly. This procedure is critical in managing conditions that arise from the accumulation of blood in the subdural space, thereby alleviating pressure and preventing further neurological damage.