What is Burr Hole Drainage?
Burr hole drainage is a surgical procedure used to remove a blood clot near the brain. These blood clots are known as subdural hematomas because they form under the dura, which is the protective covering of the brain. Hematomas usually require removal because they can compress the brain tissue and cause life-threatening complications. In certain cases, a traditional open surgery, known as a craniotomy, may be necessary. But many hematomas can successfully be removed using burr hole drainage, in which a small perforation is created through the skull to suction out the blood and relieve pressure on the brain.
Subdural hematomas may be the result of a significant trauma to the head or of a minor head injury, particularly in those with other risk factors. In patients with a chronic subdural hematoma, the blood clot might form and expand over time, with few if any symptoms initially. Some of the risks for developing a subdural hematoma include older age, use of anticoagulant medications, excessive alcohol consumption and repetitive injuries to the head.
To determine whether you are suffering from a subdural hematoma, Dr. Lipani will perform a physical and neurologic examination. Imaging of your brain will most likely be necessary, which may include a CT or MRI scan.
The Burr Hole Drainage Procedure
A burr hole drainage procedure requires the use of general anesthesia. The patient’s head is shaved at the treatment site. Once the head is correctly positioned by the surgical team, an antibiotic solution is applied to prevent infection. Dr. Lipani will make a small incision in the scalp, then use a special surgical drill to create a small perforation in the skull. The dura is cut open to reveal the hematoma. Irrigation is employed to rinse the area out. Dr. Lipani will next thoroughly drain the region via tubing to ensure that the blood clot and any excess fluid has been evacuated. Once that has been accomplished, Dr. Lipani will close the incision.
Risks of Burr Hole Drainage
While a burr hole drainage procedure is relatively common and much less invasive than open forms of brain surgery, it does still pose a number of risks. The complications of burr hole drainage may include brain injury, accumulation of fluid around the brain, seizure, stroke, weakness, paralysis, bleeding and infection.
Recovery from a Burr Hole Drainage Procedure
Patients are generally required to remain in the hospital for a period of several days following a burr hole drainage procedure. There may be some discomfort, for which your doctor will prescribe medication. A patient’s activities may be restricted for the first few weeks after surgery, including the recommendation to avoid any strenuous forms of exercise or those activities that might result in a head injury.
Many of the symptoms typically experienced with a subdural hematoma, such as headaches, balance problems, numbness, weakness and speech issues, are often resolved immediately after the surgery. Some patients require rehabilitation services to restore their previous functionality. In certain cases, seizures may persist for some time after the burr hole drainage procedure, but can generally be managed by taking anticonvulsant medication prescribed by your physician.