Do doctors really drill into a patient's head to relieve pressure?

Not so primitively.

Well, the brain itself does not feel pain so there are numerous types of brain surgery which are done with patients in a conscious state.

Also, in many cases of head trauma if there is brain swelling, it is critical for survival
to relieve the pressure to prevent permanent damage or death.

This was recently in the headlines as the cause of Natasha Richardsons death following a fall on the ski slope. The headache of which she later complained was due to the unrelieved pressure of the brain swelling. Had she gone to the ER, where they would have drilled she would most likely have survived.

I’ve also seen medical documentaries where they have not just drilled, but in critically severe cases have removed a portion of the skull in order to allow as much swelling as necessary until it could later subside.

I know this also sounds kind of weird, but they took the piece of skull and embedded it subcutaneously in the persons abdomen to keep it viable for future reattachment.

I don’t know if that’s still done currently, but evidently it was fairly standard practice.

@Buttonstc That’s so cool :)

It was done here in Australia a few months ago. A county Doctor used a household drill to save a boys life while being instructed by a specialist via telephone. It was successful.

See

There is evidence of ancient societies like the Aztecs(i think) created holes in peoples skulls to relieve pressure. Skulls have been found with what look like drilled holes.

so im sure its possible to do it freehand these days.

My cousin had the entire top half of his
skull removed post car accident. Once the swelling went down it was put back on. He’s alive and well today because of it.

The incas (or mayans or some othe mexican civilization of old) used to do it too.

Considering the length of time that the deleterious effects of pressure on the brain, I find it surprising that this is not standard protocol at every ER and Trauma center.

Whether or not your ICP (intracranial pressure) is judiciously monitored and relieved by drilling and inserting a drain to relieve it is kind of a crap shoot. Only approx thirty percent use this as a standard protocol.

In 1997 the PBS program Nova did a docu. entitled Coma where they featured a neurosurgeon, Dr. Jam Ghajar who has spearheaded the efforts to widen the use of a standardized protocol called The Guidelines which specifies this as the treatment of choice to minimize the additional effects created by the damage done by excessive ICP.

This was the program I remembered so vividly because that’s the treatment I would want if I ever had the misfortune of that type of accident. But it all depends upon what is done at whatever emergency center you end up at. Not too comforting to think about.

Anyone wanting to find out more about the guidelines and the importance of ICP can just pop his name into search and they also have a website for the Nova program with a detailed interview with him.

There are also some recent GMA clips in which he is asked for more detailed info about the Natasha Richardson case. He is obviously the go-to guy in the TBI field.

Thank you so much for all the great answers!

I’m still kind of puzzled that they would do this Freehand.

wouldn’t the person just die if the doctor pushed a bit harder?

It only makes sense to have the person’s head strapped down, and have a machine that is remote controlled, do the drilling. (and why is the drill bit so long?)

Or at least have a piece on the drill bit that will stop it from going in farther…

They usually do have the patients head immobilized for the type of surgeries where the patient is conscious.

But if they are drilling to relieve pressure the patient is in a coma. Plus it’s normally a highly experienced neurosurgeon doing the drilling. This is not a job for one of the interns :)

Presumably they have done this enough times so they know what would be too far. In one of his interviews Dr. G. pointed out that they usually drill in an area in the front of the skull to avoid areas of the brain involving language and motor skills. This is where they place the drain to do the least amount of potential damage.

They have the areas of the brain pretty well mapped out in terms of which areas control what. The whole thing is pretty fascinating.