DRILL perforation of the cranium to our knowledge has not been employed in recent years except by a few neurologic surgeons.1 The simplicity of the method and the rapidity with which it can be carried out make it especially suitable for the emergency treatment of the patient with increased intracranial pressure. At first glance it may be considered hazardous because of possible hemorrhage from ruptured cortical vessels. Our experience, however, indicates that it is safe when performed on patients with increased intracranial pressure and with due regard to anatomic and physiologic factors.
Perforation of the skull is performed by the use of a simple twist drill point 2 mm. in diameter (fig. 1). The dura mater can be perforated in a like fashion or by the use of an 18 gage lumbar puncture needle. Since the ventricular needle has little or no leeway in this small opening, it