4.8\ Burr Holes

4.8.1\ Discussion

Burr hole craniostomy is a commonly performed maneuver as part of creating craniotomy flaps, stereotactic biopsy, hematoma decompression, ventricular endoscopic procedures, insertion of ventricular catheters, drains, and electrode

a

insertion­ . Burr holes are surgical defects that traverse the full thickness of the calvarium created using various drills and can be packed with a variety of materials, such as bone wax and methyl methacrylate and may be covered with a plate (Fig. 4.12). Linear enhancement along the edges of burr holes is commonly observed as vascular granulation tissue forms, thereby potentially mimicking abscesses or neoplasms (Fig. 4.13).

b

c

Fig. 4.12  Burr holes. Axial CT image (a) shows a right parietal calvarium defect that matches the contours of the drill (encircled). Axial CT image (b) shows methyl meth-

acrylate filling the bifrontal burr holes (arrows). Axial CT image (c) shows a metallic burr hole cover (arrow)