Percutaneous epidural drainage through a burr hole

Area of Science:

• Neurosurgery
• Radiology
• Emergency Medicine

Background:

• Intracranial extradural collections can lead to elevated intracranial pressure, necessitating prompt intervention to prevent severe outcomes.
• Conventional drainage methods may pose challenges in patients with prior surgical interventions like craniectomy.
• Minimally invasive techniques are crucial for managing intracranial pathologies efficiently.

Observation:

• A patient with a history of meningioma resection and craniectomy presented with symptoms of intracranial hypertension.
• Cerebral CT revealed an extradural collection causing subfalcine herniation.
• A multidisciplinary team decided on a CT-guided percutaneous drainage approach.

Findings:

• A CT-guided percutaneous drainage of the extradural collection was successfully performed through a pre-existing burr hole.
• The patient experienced rapid symptom resolution and was discharged within 36 hours.
• This approach demonstrated safety and efficacy in managing the extradural collection.

Implications:

• CT-guided percutaneous drainage through a previous burr hole is a viable alternative for extradural collection management.
• This technique can potentially reduce operative time and patient recovery period.
• Further studies may explore the broader application of this minimally invasive approach in neurosurgical emergencies.