The Effectiveness of Burr Hole Surgery with a High Speed Drill for Chronic Subdural Hematoma: Technical Notes

Conventionally, burr hole creation has been performed using a hand-cranked drill.However, this technique carries a risk of a complication known as plunging, defined as an uncontrolled, rapid increase in drilling depth, which can result in severe injury.With technological advancements, various devices for burr hole creation have been developed.Among them, the automatic-releasing cranial perforator is useful but expensive and still carries a risk of plunging.Since October 2020, we have used a high-speed drill for burr hole creation in over 100 patients with Chronic Subdural Hematoma (CSDH).This procedure offers several advantages.Trainees can become accustomed to using a high-speed drill, and it significantly reduces the risk of plunging and brain injury.In our experience with over 100 cases, we have not encountered any major complications.Additionally, the cost is lower than that of the perforator.The smaller burr hole created by the high-speed drill also provides a better cosmetic outcome and allows for effective drainage of CSDH.This technique offers clear benefits in terms of education, safety, cost-effectiveness, and cosmetic outcomes, with no major drawbacks.Here, we report on the effectiveness of burr hole surgery using a high-speed drill.