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Threading the Needle: When a Cranial Burr Hole Is Palliative Therapy
Stephanie Hang1, Faith P Hopp2, Robert J Zalenski3,4
1Department of Internal Medicine, St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA.
Journal of Palliative Medicine
|February 8, 2022
Summary
Cranial trephination (burr hole) can be a palliative treatment for subdural hematoma (SDH) in elderly patients with good baseline function. This minimally invasive procedure can improve quality of life and neurological outcomes.
Area of Science:
- Neurosurgery
- Geriatrics
- Palliative Care
Background:
- Subdural hematoma (SDH) affects a significant number of elderly individuals, presenting complex treatment decisions.
- Treatment options range from conservative comfort care to surgical interventions like craniotomy or burr hole procedures to manage intracranial pressure.
Observation:
- A case report details a 95-year-old woman with acute on chronic SDH and aphasia.
- The patient underwent neurosurgical consultation and cranial trephination (burr hole).
Findings:
- The cranial trephination successfully reversed the patient's aphasia.
- The patient maintained independent living and good function for three years post-surgery.
Implications:
- Burr hole surgery can be a viable palliative care option for select elderly patients with SDH.
- Minimally invasive neurosurgical interventions, discussed interdisciplinary, can enhance quality of life in older adults.
