Patterns of care: burr-hole cover application for chronic subdural hematoma trepanation
EANS Academy. Vasella F. 09/27/19; 275990; EP05058
Flavio Vasella
Flavio Vasella

Access to this content is reserved for EANS members and attendees of this event. Click here to become an EANS member and gain your access to the full content of the EANS Academy

Discussion Forum (0)
Rate & Comment (0)
Background: Skin depressions may appear as undesired effects after burr-hole trepanation for the evacuation of chronic subdural hematomas (cSDH). Placement of burr-hole covers to reconstruct skull defects can prevent skin depressions, with the potential to improve the aesthetic result and patient satisfaction. The perception on its relevance appears to vary substantially among neurosurgeons. We aimed to identify current practice variations with regards to the application of burr-hole covers.
Methods: An electronic survey was sent to resident and faculty neurosurgeons practicing in different parts of the world. All completed responses between 09/2018 and 12/2018 were considered. Descriptive statistics and logistic regression were used.
Results: A total of 604 responses were obtained, of which 576 (95.4%) provided complete data. Respondents had a mean age of 42.4 years, 86.5% were male. The sample consisted of residents, fellows, junior/senior consultants, and department chairs from 79 countries (77.4% Europe, 11.8% Asia, 5.4% America, 3.5% Africa, 1.9% Australasia). Skin depressions were considered a relevant issue by 31.6% and 76.0% indicated that patients complain about skin depressions more or less frequently. Burr-hole covers are placed by 28.1% in the context of cSDH evacuation more or less frequently. The most frequent reasons for not placing a burr-hole cover were the lack of proven benefit (34.8%), followed by additional costs (21.9%) and technical difficulty (19.9%). Most (77.5%) stated that they would consider placing burr-hole covers in the future, if there was evidence for its superiority. The use of burr-hole covers varied substantially across countries, but a countries' gross domestic product per capita was not associated with its placement.
Conclusions: Only a minority of neurosurgeons' places burr-hole covers after trepanation for cSDH on a regular basis, even though the majority of participants reported complaints from patients regarding postoperative skin depressions. There are significant differences in the patterns of care among countries.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings