A burr hole procedure is most often done by a neurosurgeon who works with a team of specialized nurses. In some cases, a healthcare provider other than a neurosurgeon might need to perform the procedure. This may be the case if you have a medical emergency. The details of the procedure may vary from person to person, but a typical procedure goes like this:

• Just before the procedure, you’ll have an intravenous (IV) line put in your arm or hand. You will receive a medicine through the IV to make you relaxed and sleepy. Or, you will receive a medicine to make you sleep fully (general anesthesia).
• During the procedure, your healthcare provider will carefully watch your vital signs, such as heart rate and blood pressure.
• Hair will be trimmed in the area of the scalp.
• Numbing medicine is injected into the scalp.
• An incision is made in the scalp.
• Using a special drill, a surgeon drills one or two small holes in the skull to expose the dura.
• The surgeon then opens the dura and drains any excess fluid to reduce pressure within the skull.
• The surgeon may then place a temporary drain to continue to drain the fluid. Or the dura and scalp will be closed right away.