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.

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. The surgeon 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. The surgeon 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, the surgeon will close the incision.

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.

Patients are generally required to remain in the hospital for a period of several days following a burr hole drainage procedure. A patient’s activities may be restricted for the first few weeks after surgery, and they are advised to avoid any strenuous forms of exercise or 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 prescription anticonvulsant medication.

• MedlinePlus
• National Institutes of Health
• Centers for Disease Control and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• S. Department of Health & Human Services
• S. National Library of Medicine
• WebMD