The Helm of Balduran. In most cases the Helm is better - unless you have a party that can't wear helmets, or you just want to take the Claw along for fun.
the only time i take the claw of kazgaroth over is if im playing a character where they won't suffer a HP penalty for wearing it in melee, like a swashbcukler or blade
if you're a swashbuckler or blade with 18 CON the only real drawback is the penalty to save vs death, but in ToB you can get that iounstone to even that out or perhaps even wear the cloak of displacement to help mitigate that penalty
or better yet, if you have a cleric/thief that goes into melee this item could work out real well for them as well, and if im not mistaken they have good saves vs death
plus if you're a dwarf or halfling they get that sexy bonus on their save vs death as well, so it works super swell with a dwarven swashbuckler
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if you're a swashbuckler or blade with 18 CON the only real drawback is the penalty to save vs death, but in ToB you can get that iounstone to even that out or perhaps even wear the cloak of displacement to help mitigate that penalty
or better yet, if you have a cleric/thief that goes into melee this item could work out real well for them as well, and if im not mistaken they have good saves vs death
plus if you're a dwarf or halfling they get that sexy bonus on their save vs death as well, so it works super swell with a dwarven swashbuckler