title: 'Plunging' during burr hole craniostomy: a persistent problem amongst neurosurgeons in Britain and Ireland.
abstract: The inadvertent 'plunging' of an instrument into the cranial cavity is a feared complication of drilling a burr hole and while anecdotes abound, little is known about the extent or the consequences of this problem. A survey by anonymous postal questionnaire of 304 neurosurgeons in Britain and Ireland was conducted to analyse the extent of this complication. Of respondents, 65.6% had experienced 'plunging', 22.3% having 'plunged' at least twice, indicating a high prevalence of this complication. The Cushing perforator was implicated by most. 'Plunging' carried a 12% risk of death or permanent neurological morbidity. The authors analyse the prevalence and significance of this preventable complication, and discuss various options available to minimize its occurrence.
authors.affiliation: Department of Neurosurgery, Regional Neurosciences Unit, Royal Victoria Hospital, Belfast, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Caird
authors.forename: K A
authors.initials: KA
authors.lastname: Choudhari
mesh_terms: D016063:Blood Loss, Surgical; D003399:Craniotomy / Q000009:adverse effects* / Q000295:instrumentation; D020197:Head Injuries, Penetrating / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000209:etiology; D007431:Intraoperative Complications / Q000453:epidemiology*; D007494:Ireland / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology