Monday, February 28, 2011

Melt's Medical Monday





Burr Hole

A burr hole for subdural hematoma is performed to remove a hemorrhage (blood clot) from around the surface of the brain. The location of the blood clot is beneath the firm covering of the brain known as the dura mater, and is therefore called subdural hematoma. Generally, when a blood clot is moderately old (at least two to three weeks), it may be drained through a small hole in the skull, and a large craniotomy flap (opening in the skull) might be avoided.

The patient will be taken to the operating room and put to sleep under general anesthesia. The head will be partially shaved, to expose the area of operation. The head may simply rest on towels, or it may be placed in three fixation points (Mayfield head pins). The area where surgery is to be performed is then "prepped and draped" using an antibiotic solution. Next, the surgeon will make an incision, and reflect the scalp over the area of the hematoma. Then, an air powered drill is used to make a hole in the skull. The dura mater (tough covering of the brain) is then opened. The hematoma (blood clot) is now seen, and the surgeon will irrigate some of it out, and may pass a drain around the brain to provide post-operative drainage. The surgeon will then close the scalp.









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