Burr hole is not burr hole: technical considerations to the evacuation of chronic subdural hematomas

The organization of a multicenter survey about chronic subdural hematomas has triggered the discussion on different surgical techniques of burr hole evacuation. Such a standard operation gives neurosurgeons plenty of scope for creating their own way. The procedure presented is one burr hole with a closed drainage system. In detail, each single step is enrolled: the planning of the burr hole, positioning, direction of skin incision, opening of the dura, drain positioning, channeling through the galea, and postoperative care. We present a thorough summary that could serve as a common standard and as a basis for comparison of future trials.