Burr hole trephination for chronic subdural hematoma

Operated by Jun kyu Hwang

Burr-hole trephination is the most effective surgical procedure for the evacuation of chronic subdural hematoma.

As time passes, the hematoma mixes with cerebrospinal fluid and transforms into a drainable liquid. By creating a small burr hole in the skull and inserting a catheter, the hematoma can be effectively evacuated.

Since the primary goal of the procedure is decompression, some residual hematoma may remain in the cavity after catheter removal; however, this usually resolves spontaneously during long-term follow-up.

The procedure involves a skin incision of approximately 2–3 cm, burr-hole trephination, dural opening, and insertion of a drainage catheter. Although the catheter is most commonly placed at the parietal eminence, the location may vary depending on the patient’s condition.