A burr hole is a small hole drilled into your skull. Burr holes are used when brain surgery becomes necessary.
A burr hole itself can be a medical procedure that treats a brain condition, such as:
In many cases, burr holes are part of emergency procedures resulting from traumatic injuries and used to:
- relieve pressure on the brain
- drain blood from the brain after a traumatic injury
- remove shrapnel or other objects lodged in the skull
Surgeons also use burr holes as part of a larger-scale treatment process. They may be needed to:
- insert a medical device
- remove tumors
- biopsy a brain tumor
Burr holes are a first step to larger, complicated brain surgeries as well. To perform a surgery on your brain, surgeons need to get access to the soft tissue underneath your skull. A burr hole creates an entryway that surgeons can use to carefully guide their instruments into your brain.
In some cases, several burr holes can be placed at different locations on your skull to allow surgeons access to a wider area of the brain.
Although the process to putting a burr hole in the skull is a delicate one, it’s relatively routine.
A neurosurgeon who specializes in the brain will map out where exactly the burr hole, or holes, need to go. They’ll use the results from diagnostic imaging tests your doctors have collected to assess your condition and decide on your treatment.
After your neurosurgeon determines the location of the burr hole, they can begin the procedure. Here are the general steps:
- You’ll most likely be under general anesthesia during the procedure so you don’t feel any pain. If this is the case, you’ll also have a catheter during the procedure and in the hours afterward.
- Your surgeon will shave and disinfect the area where the burr hole is needed. Once they remove the hair, they’ll wipe down your skin with a sterile cleaning solution to reduce the risk of infection.
- Your surgeon will administer an additional level of anesthesia to your scalp via a needle so you won’t feel the burr hole being inserted.
- Your surgeon will make an incision on your scalp to expose your skull.
- Using a special drill, your surgeon will insert the burr hole into the skull. The hole may be used right away to drain blood or other fluid causing pressure on the brain. It may be sewn closed at the end of the procedure that you need or left open with a drain or shunt attached.
- Once the burr hole is complete, you’ll move to a recovery area. You’ll need to stay in the hospital for a couple of nights to make sure your vital signs are stable and to rule out possible infection.
As with any surgery, burr hole surgery carries a risk of side effects. They include:
- bleeding more than a normal amount
- blood clots
- complications from anesthesia
- risk of infection
There are also risks specific to a burr hole procedure. Surgeries that involve the brain can have lasting side effects. Risks include:
- seizure during procedure
- brain swelling
- bleeding from the brain
Burr hole surgery is a serious medical procedure, and it does carry a risk of death.
A craniotomy (also called a craniectomy) is the main treatment for subdural hematomas that happen after a traumatic skull injury. Other conditions, like intracranial hypertension, sometimes call for this procedure.
In general, burr holes are less invasive than a craniotomy. During a craniotomy, a part of your skull is removed through a temporary incision. After your surgeon is done needing access to your brain, the section of your skull is placed back over your brain and secured with screws or metal plates.
The recovery from a burr hole surgery varies widely. The time it takes to recover has more to do with why you needed the surgery than it does with the procedure itself.
Once you wake up from the anesthesia, you may feel a throbbing or soreness in the area where the burr hole was inserted. You may be able to manage the pain with over-the-counter pain medication.
Most of your recovery will take place in an intensive care unit in the hospital. Your doctor may prescribe antibiotics as a preventive measure against infection.
Your doctor will work closely with you to manage your recovery. Immediately after the surgery, you’ll be able to resume eating and drinking as you would normally.
You’ll need to be cleared by your doctor before you drive or operate machinery. You’ll also need to avoid any activity in which you could receive a blow to the head.
Your doctor will give you instructions about how to care for your wound. They’ll also let you know about any needed follow-up appointments.
In some cases, you’ll need to return to your doctor to have stitches or a drain removed from the site of the burr hole. In recent years, some doctors have started covering burr holes with titanium plates after they’re no longer needed.
Burr hole surgery is usually an emergency procedure. That means that most people don’t have time to prepare before having it done.
If you’re having burr holes inserted to remove a tumor, insert a medical device, or treat epilepsy, you may have some forewarning that you’ll need this surgery.
You may be asked to shave your head before the procedure and not eat or drink anything after midnight on the day before surgery.
Burr hole surgery is a serious procedure performed under the supervision of a neurosurgeon. It’s usually performed in emergency cases when pressure on the brain must be relieved right away.
After burr hole surgery, your recovery timeline depends on the health condition that made you need the surgery. Be sure to follow all postoperative instructions carefully.