Everything You Need to Know About Burr Hole Procedures

Burr Holes are used for many purposes such as:

1) To drain blood from wounds; 2) To prevent infection; 3) For drainage of urine; 4) To provide ventilation during surgery or other activities; 5) To create a place where patients can rest when they cannot walk well due to physical disabilities.

The following procedures are performed with Burr holes:

1) Hemostasis – keeping a wound clean and dry.

2) Blood collection – collecting blood after it has been drained from the body.

3) Circulation – pumping blood through the circulatory system.

4) Drainage – draining blood out of a wound using a tube called a catheter.

5) Dressing – dressing wounds.

6) Excision – cutting off part of the body.

7) Extraction – removing parts of the body.

8) Filling – filling a wound with fluid or liquid.

9) Gastric lavage -gassing up a wound with air and water to relieve pressure inside the body.

10) Grafting – grafting skin onto another part of the body so that it grows over the wound instead of going through it. 11) Infiltration – injecting liquid into a wound.

12) Inunction – anointing the body with oil or ointment. 13) Irrigation – washing out a wound using flowing water or air. 14) Localization – finding and stopping bleeding in a wound. 15) Myotomy – cutting open the chest so that the heart can be seen outside of the body. 16) Packing – filling a wound with material to stop it from bleeding or closing. 17) Paracentesis – puncturing the skin and drawing out liquid using a syringe. 18) Pithing – cutting a living animal’s spinal cord so that it cannot move its lower body. 19) Puncture – making a small cut in the skin with a sharp object. 20) Suture – stitching a wound closed. 21) Suturing – sewing a wound together to heal it. 22) Thoracocentesis – puncturing the chest so that liquid can be drained using a syringe. 23) Thoracotomy – cutting open the chest to treat internal bleeding. 24) Trocar – a knife-like medical instrument used to make small holes in internal organs.

There are many procedure steps in burr hole surgery. The first step is the patient assessment.

In this step the medical professional assesses the patient’s condition. The second step is equipment preparation. Here all sterilization, surgical tools and other equipment are prepared for use in the procedure. The third step is the surgical incision. In this step a small hole is made in the head so that the surgeon can work with the dura mater. The fourth step is dura division. In this step the surgeon cuts open the dura to expose the arachnoid mater. The fifth step is arachnoid division. In this step the arachnoid is cut open and the surgeon examines it to check if there any signs of infection or bleeding. The sixth step is resection of skull. In this step the surgeon cuts open a small piece of skull to create room for working. The seventh step is removal of bone flap. In this step the surgeon takes out a small piece of bone to create more working space. The last step is wound closure. In this step the wound is stitched and bandaged to allow it heal.

There are many procedure tips for burr hole surgery. The first tip is to make sure that you feel comfortable with your surgeon.

Ask them any questions that you may have. The second tip is to make sure that you are mentally prepared for the surgery and what may happen after it. The third tip is to make a list of questions to ask your surgeon about the procedure.

Wake up call

You wake up in a hospital room. You see your parents sitting in recliners next to your bed and they turn their heads to look at you.

Your mother has been crying and your father looks like he just got done yelling at someone.

“You had us worried for a second there son.” He says strongly.

What happened?”

You ask still groggy from the anesthetic.

Your mother rushes to hug you and you sit up slowly in bed. You see bandages wrapped around your head but you don’t feel any pain at all other than a mild headache.

“You tried to off yourself.” Your father says bluntly.

You notice a change in your mother’s expression and she hurries out of the room. You father speaks with a different, moreso angry tone in his voice.

“You selfishly put your mother through hell. I’m really disappointed in you.

I thought I had brought you up better than that.”

You shrink back in your bed from the verbal assault. Your father soon leaves the room and doesn’t return.

You can hear him talking with your mother in the next room saying that he is taking her out to dinner to make up for all of this. You feel tears begin to roll down your cheek, but you wipe them away. You just try to remind yourself of why you offed yourself in the first place.

You hear a knock on the door and a ladies’ voice calls out, “I have some food here for Matthew.” You call out “Come in.” and a pretty young lady around your age wheeling a food cart enters.

She has auburn hair and fair skin. She smiles and introduces herself as Heather, your nurse. You wonder if she is Steve’s sister.

Heather explains that since you had just undergone surgery, the doctors wanted you to have something solid to eat rather than just juice or a soft meal. She places the food in front of you.

It is mashed potatoes, gravy, butter, and some cured meat. It looks and smells delicious. You realize you are very hungry and haven’t eaten since yesterday at lunch.

As Heather leaves the room she encourages you to call if you need anything else. You dig in and eat all of your meal.

It is delicious.

When you are done you start feeling drowsy and decide to get some rest.

Dreams

You are unsure of whether you are asleep or awake. You find yourself in a room with tan walls and a large sliding door that is wide open.

You walk outside and see a blue sky with fluffy white clouds. The sun shines brightly and you feel its warmth on your face.

There is a hammock tied between two palm trees in your yard. You find yourself in the hammock.

You lay down in it and begin swinging back and forth. You close your eyes and enjoy the feeling of flying and the wind blowing through your hair.

You hear a voice from behind you say, “This doesn’t seem right somehow.” You turn around and see a woman with long black hair and brown eyes looking at you.

She wears a surgeon’s gown like yours but her sleeves are rolled up. You know her as Heather, your nurse.

You reply to her, “It doesn’t? Why not?”

“This is too easy. Maybe you aren’t learning anything from this.” Heather says.

What do you mean?”

You ask.

You stand up and walk over to her. She holds out her hand and you take it.

She leads you inside. The sliding door closes shut behind you. It is dark and you begin to hear a low rumble that quickly gets louder and louder until it feels like your ears are about to explode. Then everything goes black.

You wake up in your hospital bed with a start. You are covered in sweat and breathing heavily.

Heather rushes into the room and sees that you are awake.

“You’re awake!

How are you feeling?”

She asks, her face showing deep concern.

“Okay, I think. A bit groggy and really thirsty.” You reply as she hands you a cup of water.

“You had us worried there for a moment. You had a bad reaction to your surgery and almost didn’t make it.” Heather explains.

“It seems you have recovered, however.

Do you know where you are?”

You look around the room and everything comes back to you. You remember the crash, the flight, the surgery, and even the strange dream you just had. It all came back in a rush like a fist to your gut.

“I’m in the hospital.” You reply.

“That’s right! You’re in the hospital!” Heather exclaims with a big smile. “

Do you know what today is?”

You think for a moment and then reply, “Thursday?”

“Very good!

Do you know what year it is?”

Heather continues to ask you questions.

“2050.” You answer again.

“Wow! You’re right!

How did you know all of that?”

Heather seems genuinely shocked and impressed by your answers.

“I was a pilot in the war. I used to have an apartment in New York before it was destroyed.

I was engaged… but she’s gone now. Everything is gone.” Your face becomes sad and you start to choke up. “I’m the last one. There is nobody left.”

You begin to cry, but the tears don’t come. You haven’t any more water left in your body to produce them.

Heather sits by your side and holds your hand.

“You’re not the last one, silly! You’ve got me!” She gives you a hug and tells you that she will be here for you every step of the way.

You spend the next few days resting and recovering in the hospital. Heather stays with you the whole time except for when she is working.

You have visitors too. Captain Eckard comes to see you. So does Jones and a few of the other men from your unit. They all bring you gifts and news of the outside world. Most of the news isn’t good.

The war still rages on and it seems like it is going badly. Most of Europe is lost, China fell two years ago, and things are not going well in North America either.

It’s like the whole world has gone mad.

Seeing all of this again puts you in a dark mood. You don’t want to get out of bed, you don’t want to eat, and you stare at the walls for hours on end.

Heather does her best to take care of you, but even she can’t keep your spirits up. You just feel like all hope is lost and there is no going back.

One night she comes into your room with a sad look on her face. You know that she has been worried about you and the way you’ve been acting.

“I’m leaving.” She says sadly.

What? Why?”

You ask in a completely blank tone of voice. You don’t really care though.

“Staying here is doing me no good and it’s not doing you any good either. I’ll only drag you down into the depths of despair, and I can’t afford to lose another comrade.

Not after losing so many recently.”

“You won’t lose me. I’ll be here for a long time.” You say apathetically.

“I know I won’t lose you physically, but I believe this place will take a toll on your mind and spirit. I saw how happy you used to be at the base and then when you got here and saw what was going on it was like you became a different person.

You used to smile and laugh, and now its like you don’t care about anything.”

“That’s because there is nothing to care about. Its all gone.

The world is doomed and I’m never going to get out of this place. Its just a matter of time.”

Heather gets a little frustrated with you and turns her head. You can tell she is holding back tears.

“You’re wrong. The world isn’t doomed.

Its just changed. We have to move on and adapt. You’re just holding yourself back.”

You don’t say anything you just turn your head away from her and close your eyes hoping that she’ll get the hint and leave.

She doesn’t.

“I can see that speaking to you about this is doing no good, so I’m going to have to resort to more direct methods. Please don’t take this the wrong way.”

You turn your head back to see her leaning over the bed, her hands resting on your chest. Before you can react she leans in and kisses you on the lips.

The sensation is strange to you, as you haven’t kissed anyone since before the invasion. It feels good.

Your senses quickly return though and you shove her off of you.

What the hell was that for?”

“Psychological torture. They used to do this to prisoners in the middle ages too. It doesn’t really work on everyone, but I had no way of knowing if it would on you.”

“Well it did, but that doesn’t give you the right to do that!” You exclaim.

“I know, but I was getting desperate.” Heather says getting off the bed.

“I’m sorry, but I’ve got to go now. I hope to see you again some day.”

Heather turns and leaves your room. You don’t even get up to see her out, but just lay in bed thinking about what happened.

Is this what’s been missing from your life? A relationship with another human being?

Heather and you could never really be together though. She is still human and you are no longer that. You’re something else.

You’re a mockery of what you once were, just like the sham that the world has become.

You have dismissed all the anger you once felt, and what is left?

Nothing. You are an empty vessel drifting through the darkness.

You stare at the ceiling fan as it rotates around and around. It has probably been spinning for over a decade now, and shows no signs of stopping.

You’re trapped just like it, in a never-ending cycle. You lie in bed, go to work, then come back here.

Life.

Is this what it feels like?

Sources & references used in this article:

How To Perform an Emergency Burr Hole Procedure by D Beffa – acepnow.com

Ultrasound-based navigation during intracranial burr hole procedures: experience in a series of 100 cases by M Strowitzki, JR Moringlane, WI Steudel – Surgical neurology, 2000 – Elsevier

A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas by T Nishihara, A Teraoka, A Morita, K Ueki, K Takai… – Journal of …, 2000 – thejns.org

Hydroxyapatite/poly-L-lactide acid screws have better biocompatibility and femoral burr hole closure than does poly-L-lactide acid alone by H Akagi, M Iwata, T Ichinohe… – Journal of …, 2014 – journals.sagepub.com

Improved long-term survival with subdural drains following evacuation of chronic subdural haematoma by MR Guilfoyle, PJA Hutchinson, T Santarius – Acta neurochirurgica, 2017 – Springer

Otogenic brain abscess: review of 41 cases by EN Myers, L Sennaroglu… – Otolaryngology–Head and …, 2000 – journals.sagepub.com