Trepanation of the skull is a neurosurgical procedure for which patients with diagnosed intracranial hematoma are most often qualified. Trepanation allows you to remove it in liquid form. This method is also used to insert a sensor for measuring intracranial pressure. Sometimes scout trepanation is also performed.

Trepanation of the skullconsists in making a hole revealing the meninges and the brain. Thanks to this, it is possible to reach the cranial cavity. Holes in the bone are drilled with a hand or electric drill called a trepan.

The word "trepanation" comes from the Greek trypanon and means "drill".

Trepanation of the skull is performed primarily in the case of a hematoma of the brain. Such decompression reduces the risk of the hematoma recurring and relieves the pressure on delicate brain tissue. In some diseases (e.g. with hydrocephalus or cerebral edema), special catheters are inserted through the trepanation holes to measure the intracranial pressure.

Reconnaissance trepanation

Trepanationexploratory treatment involves making several trepanation holes in order to determine the cause of the ailments. It is performed urgently, e.g. in the case of a sudden deterioration of the patient's well-being along with the features of the brain being deepened.

In orthopedics, trepanation of long bones, vertebrae and pelvis is the initial stage of bone productive surgery, and in dentistry, tooth trepanation is performed in order to open the tooth chamber in inflammation or gangrene of the pulp.

The indication for trepanation is not only the suspicion of a skull fracture, but also, for example, the sudden appearance of paresis, speech or sensory disorders, and pupil asymmetry. Scout trepanation is also performed when a skull fracture is suspected. During exploratory trepanation, several holes are drilled in the skull and it is drilled in the frontal, parietal and temporal areas. If the cause of the ailment is not found, further holes are made. After surgery, drains are sometimes left in place to reduce the risk of the hematoma returning.

Complications of skull trepanation

Possible complications after trepanation of the skull are:

  • intracerebral hematoma
  • formation of an acute hematomaepidural or subdural
  • hypoxia
  • brain swelling
  • meningitis
  • subdural empyema
  • operating wound infection
Important

Trepanation procedures of the skull were carried out in South America as early as around 400 BCE, but then only every third patient survived the operation. During the Inca era, the survival rate increased to 80-90 percent. Patients were mostly men with head injuries as a result of fighting. Surgeons of that time avoided blood vessels and revealed the dura mater just under the skull. They often removed part of the patient's skull and operated on his brain. Patients were anesthetized with cocaine, tobacco or beer.

Category:

Neurology