A burr hole drainage refers to a hole that is surgically placed in the skull or the cranium to facilitate further surgery or disrupt the skull depending upon the nature of the issue. This surgery is used for a variety of reasons which include to make larger craniotomy, allow cerebrospinal fluid drainage, pass the drainage catheters or evacuate the chronic blood.
This procedure is a necessary part of the huge majority of the brain surgeries. As the skull is very hard, creating an incision with a scalpel is impossible also using a saw to cut the skill requires special skills and techniques for preventing the injury to the brain. A burr hole makes it possible to create controlled cuts in the skill without risking penetration to the delicate brain tissues. Basically, the burr hole is used as the incision to perform the brain surgery.
Burr Hole Drainage Procedure
During the burr hole drainage procedure one or more holes are made in the skull in order to release the excess fluid pressure in the brain caused by chronic subdural hematoma or the blood clot on the brain. This procedure is performed under local anesthesia.
This surgery is performed by a neurosurgeon who is specifically trained in the brain and spine surgery and this practice is known as neurosurgery. Before this surgery, the area of the scalp of the patient where this procedure must be performed will be shaved clean of the hair. The skin will be prepared with a special solution designed to eliminate the germs on the surface of the skin. This will be done either immediately prior to the surgery or after the anesthesia is given.
The patient will be intubated and placed on a ventilator if they are not already receiving assistance with breathing after the anesthesia provider has administered sedation. The anesthesia will take effect within moments and then the patient will be positioned for surgery. The procedure may be performed either by supporting the head with towels, pillows, head pins to hold the head still in the most suitable position for the surgery.
The initial incision is made in the scalp so that the skin can be pulled away from the surgery site. A specialized air drill that is designed to stop drilling once the skull is penetrated is used to prevent the injury to the brain. Once the burr hole is completed, then the an additional incision is made in the dura, the tough covering of the brain. It appears as a thin film, but it is quite strong and must be moved aside. This is followed by draining the fluid from the affected area. Once the procedure is completed, then the dura is stitched together and the skin is placed back to the normal position and the stitches or the staples are used to close the incision.
Depending upon the nature of the surgery, the area may be lightly covered with minimal dressing or the head may be wrapped with bandages.