PEMBENTANGAN SATU PROSEDUR YANG ANDA PILIH MELIPUTI ASPEK BERIKUT:
1. PENGENALAN
2. ISI PEMBENTANGAN:
-INDIKASI UTK PROSEDUR
-BARINGAN, PERSEDIAAN KULIT DAN DRAPING PESAKIT UTK PEMBEDAHAN
-TERANGKAN BERKENAAN PROSEDUR BERMULA DARI INSISI HINGGA DRESSING DILAKUKAN
(ADD ON GAMBAR RAJAH)
3. KESIMPULAN
4. APA7
5. PRESENT ON 13th MARCH
PENGENALAN
Burr holes are small holes that a neurosurgeon makes in the skull. Burr holes are used to help relieve
pressure on the brain when fluid, such as blood, builds up and starts to compress brain tissue.
A layer of thin tissues called meninges surround and help protect the brain. These meninges contain
blood vessels that carry blood to and from the brain. The dura is the outermost of these meninges.
A head injury can cause one or more of these blood vessels to tear and bleed. A sudden tear might
cause blood to build up very suddenly. With a small tear, the blood might build up more slowly.
Blood might start to build up just below the dura mater. This causes something called a subdural
hematoma. Tears in different blood vessels may cause blood to build up just above the dura layer,
causing an epidural hematoma. A hematoma is when blood collects in an area and causes swelling.
This buildup of blood is dangerous. As the blood builds, it pushes up against the skull and has
nowhere to go. If the blood starts to compress the brain, it can lead to symptoms or even death if
not treated.
There are other reasons why you might need a burr hole procedure. Neurosurgeons may perform a
burr hole procedure to relieve pressure around the brain due to:
A sudden (acute) subdural hematoma
An ongoing (chronic) subdural hematoma
An epidural hematoma
Certain kinds of brain cancer
Buildup of pus around the meninges
Hydrocephalus
Certain kinds of bleeds from the brain itself (rare)
In cases of large hematomas or solid clots, your healthcare provider may advise another procedure
to remove the material around the brain. For example, a surgeon may remove a larger piece of bone
from the skull to treat the brain, and then put the piece of skull back in place to heal. This is called a
craniotomy. Or, the surgeon may not put the bone back in place. This is called a craniectomy.
(https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/burr-holes)
Burr hole Indications
Epidural or subdural hematoma with midline shift on imaging and unequal pupils on exam.[3]
GCS <8
Anticipated extended time to assessment/treatment by neurosurgeon.
Equipment Needed
Cranial access kit
o Razor
o Scalpel
o Self-retaining retractors
o Drill (manual or air/electric powered)
Should have both sharp (penetrator) and dull drill bits or a drill bit with
appropriate "clutch" mechanism (preferred)
o Blunt and sharp hooks
o Hemostats and forceps
Sterile PPE
Chlorhexidine or betadine
Sterile saline
Electrocautery (Bovie), if available
(https://wikem.org/wiki/Burr_hole#:~:text=Contraindications&text=In%20absence%20of
%20imaging%20(e.g.,trauma%20and%20unequal%20pupils%2C%20etc.)
Operative images of the incision
(a), the burr hole showing the EDH
(b), a rigid endoscope illuminating the cavity
(c), stages of evacuation
(d, e), a 70-degree endoscope view showing most of the peripheral portion of the cavity
(f). *Bone, # bent suction tip. A burr hole showing the evacuated cavity
(g) and scar site at follow-up
(h). The measured lengths of burr holes are shown
(I) 2.94 cm, (J) 2.48 cm and (K) 2.17 cm
(https://www.researchgate.net/figure/Operative-images-of-the-incision-a-the-burr-hole-showing-
the-EDH-b-a-rigid_fig2_303775085)
