FAQs
What is a burr
hole surgery?
A burr hole refers to the hole formed by drilling through the skull. A drill about the diameter of a 20p coin is used. This type of surgery will leave a hole in the skull following surgery which, in adults, will not grow back.
Burr hole drainage is the most common operation for cSDH. As most cSDH are liquid (like water), this hole is sufficient to drain the cSDH. Typically two holes are drilled about 15cm apart, from two separate skin incisions.
What is a craniotomy surgery?
A craniotomy is an operation which involves removing a disc of the skull. A craniotomy is sometimes used to treat cSDH, particularly when the haemotoma is still solid and will not wash free through a single burr hole. Once the procedure is complete, the disc of bone is replaced and secured with clips.
Will I have a scar from my surgery?
All surgery will leave a scar, and healing tends to differ from person to person. In most people, this will be hidden once their hair grows back. A small depression can often still be felt over the burr hole, where there is no longer bone underneath the skin. This is not thought to be of any consequence, but is the focus on an ongoing research study.
Can steroids be used to treat cSDH?
Historically steroids were used by some professionals to treat cSDH. There was a belief these could help them disappear and prevent them returning after surgery. However recent landmark studies have shown that these do more harm than good.
Can my Chronic Subdural Haematoma return?
1 in 10 cSDH will reform after surgery. Should symptoms start again, you should attend your local A/E (Emergency Department) for a further CT scan.
When can I restart medication that thins my blood?
If and when to restart medication that thins the blood is not currently known. Examples of blood thinning medication include Aspirin, Clopidogrel, Tocagrelol, Warfarin, Rivoroxaban, Apixaban and Edoxaban.
This decision must currently come down to a judgement based on the individual circumstances. It should be discussed with your Neurosurgeon if applicable before discharge.
Factors to consider are the risks of a SDH reforming (e.g. if the subdural is still healing after surgery) or risks of causing a new SDH (e.g. if the patient is prone to falls) versus the risks of remaining without it (e.g. worsening the condition they are given to treat; to prevent heart attacks or strokes for example).
Can I drive my car?
The rules around driving will depend on the license jurisdiction, the nature of the surgery that has occurred and the extent of recovery.
It is therefore always advised to confirm with your license issuer. They may often seek further information from your Neurosurgeon.
In the UK, for those with a type 1 license (non professional), undergoing a ‘burr hole drainage’ and recovering without any symptoms, there is generally no suspension.
I suffered a seizure, and I am taking medication. Will I have to take this medication forever?
This is a question best discussed with your healthcare professionals, as the best strategy will depend on individual circumstances.
Broadly, if the seizure was caused by the cSDH, which has now been treated and there are no lasting signs of disability from the cSDH, it is unlikely that further seizures will reoccur, and seizure medication could be gradually stopped.
Ultimately the only way to know is to try without. Some patients prefer to continue the medication, as they are able to tolerate it, and remain concerned about the risk of further seizures or in some cases just the inconvenience (for example, a further seizure would prolong the period of time for which they are unable to drive).
If you are thinking about stopping seizure medication it is important to seek medical advice, as this must be done gradually to avoid provoking further seizures.