Vols. Videos

Burr Holes and Bone Flaps

Last Updated: September 27, 2018

Figure 1: Harvey Cushing illustrated an osteoplastic craniotomy and cortical mapping in a patient who suffered from a gunshot wound (illustration courtesy of the Cushing Brain Tumor Registry at Yale University).

The creation of burr holes and bone flaps is among the most fundamental procedures in cranial surgery and their timely completion improves operative efficacy. Although simple and straightforward, these procedures are not without risks. Most importantly, the operator should be intimately familiar with complication avoidance strategies to minimize morbidity from these relatively basic steps of the operation.

Figure 2: The skull bone contains the outer and inner cortical bone layers (tables) separated by cancellous bone. This anatomic relationship is important during creation of...