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A burr hole procedure is a neurosurgical technique in which one or more small circular openings are drilled through the skull. The openings allow access to the tissues and spaces beneath the skull without creating a large bone flap. Burr holes are commonly used to drain chronic subdural hematomas. They can also provide access for selected drains, biopsies, monitoring devices, or other neurosurgical procedures.
read more about burr hole procedure ...The procedure is often performed when a chronic subdural hematoma compresses the brain and causes symptoms such as headache, confusion, weakness, balance problems, or reduced consciousness. Draining the collection can relieve pressure and allow the brain to re-expand. Burr holes can also be used as part of another operation when limited cranial access is needed. The choice between burr-hole drainage, twist-drill drainage, craniotomy, or another approach depends on the type and organization of the collection.
The surgeon identifies the planned site using imaging and makes a small scalp incision. A drill creates one or more openings in the skull, and the covering layers are opened carefully to reach the collection or target. For chronic subdural hematoma, liquefied blood is drained and the space can be irrigated. A subdural or subperiosteal drain is commonly left temporarily because postoperative drainage reduces recurrence risk.
Neurological status, blood pressure, wound condition, and drain output are monitored closely after surgery. Follow-up computed tomography can be used when symptoms, clinical course, or local protocol indicate a need to assess residual or recurrent bleeding. Many patients improve as pressure on the brain decreases, but recovery also depends on age, brain injury, medications, and other medical conditions. Anticoagulant or antiplatelet therapy is restarted only according to an individualized plan.
Possible complications include recurrent subdural hematoma, new bleeding, infection, seizures, pneumocephalus, brain injury, stroke, or problems related to anesthesia. A drain can become blocked, displaced, or contribute to infection. Rapid shifts in intracranial pressure can rarely lead to serious bleeding in another location. Some recurrent or organized hematomas require repeat burr-hole drainage or a larger craniotomy.
No. A burr hole is a small drilled opening, while a craniotomy removes a larger temporary bone flap to provide wider access.
Yes. Burr-hole evacuation with temporary drainage is a common first-line surgical approach for symptomatic chronic subdural hematoma.
For chronic subdural hematoma, a temporary drain is commonly placed because postoperative drainage reduces the chance of recurrence. Not every burr-hole procedure requires one.
Yes. Recurrence is a recognized complication and can require repeat drainage or another surgical approach.
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