Treatment of subdural hematoma is always surgical, explains WebMD. Surgical possibilities include burr hole trephination, craniotomy and craniectomy, all of which involve the drilling or removal of a portion of skull to physically access and remove the hematoma in the brain.
A subdura hematoma is the abnormal build-up of blood underneath the dura layer of tissue that surrounds the brain, according to the U.S. Library of Medicine. As such, all treatment procedures focus on physically accessing the afflicted area to siphon the blood away.
The three surgical procedures differ in degrees of invasiveness and trauma, notes WebMD. The first, burr hole trephination, involves drilling a hole in the skull over the area of the hematoma and drawing blood out through the hole. The second, craniotomy, is a more invasive procedure that removes an entire section of the skull in order to drain the blood; the surgeon replaces the removed section of skull upon completion of the procedure. The last possibility, craniectomy, is a rarely performed procedure only used when the hematoma remains and does not subside after conventional drainage. It involves the removal of a section of the skull for an extended period of time to allow the injured brain to swell without permanent damage.