Burr hole microsurgery in treatment of patients with intracranial lesions: Experience of 44 clinical cases

Abstract

Background: Modern technical capabilities have made minimally invasive surgery increasingly popular. Small incisions can reduce surgical duration and the degree of tissue trauma, which reduces the risk of complications. Burr hole microsurgery is a relatively new minimally invasive technique used in neurosurgery. The objective of this study was to assess the feasibility and outcomes of using burr hole microsurgery for the management of intracranial lesions. Methods: Forty-four adults were treated with burr hole microsurgery. Patients were divided into groups according to the presence of (1) brain tumors (n = 20); (2) congenital brain cysts (n = 16); (3) cavernous angiomas (n = 3); and (4) neurovascular conflicts of the 5th cranial nerve (n = 5). All surgical interventions were performed using the “MARI” device. Results: The transcortical approach was used to remove 16 brain tumors, and 2 brain tumors were biopsied. In the two tumor biopsy cases, the parasagittal interhemispheric route was used. Gross total resection was achieved in 10 cases (62.5%) when tumor size reached up to 4 cm, subtotal resection was achieved in four cases (25%) in large tumors, and partial resection in two cases (12.5%). In patients with congenital cysts, cavernous angiomas, trigeminal neuralgia, and symptomatic regression were noted the postoperative period. The surgical duration was 30–180 min (median, 75 min). A hemorrhagic complication was observed in one case. Significant postoperative complications and mortality were not observed. Conclusion: Burr hole microsurgery can treat different intracranial lesions effectively. Despite a smaller craniotomy diameter of 11–14 mm compared with keyhole approaches, surgery was successful.