Craniotomy

Summary
A craniotomy is an operation to open the skull (cranium) in order to access the brain for surgical repair. Conditions that require craniotomy and surgical repair include brain cancers, infections, abscesses, cerebral oedema (swelling of the brain) and bleeding within the skull. Share this article

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(ike any other part of the body, the brain is susceptible to bleeding, infection, trauma and other forms of damage. "his damage or alteration in brain function sometimes requires brain surgery to diagnose or treat these problems. A craniotomy is an operation to open the skull (cranium) in order to access the brain for surgical repair. "here are many different types of brain surgery, but the reco'ery process following craniotomy is much the same in most cases.

Conditions requiring a craniotomy

Some of the conditions that require craniotomy and surgical repair include) *rain cancers +nfections

Abscesses Cerebral oedema (swelling of the brain) *leeding within the skull.

Medical issues to consider

+f left untreated, any condition requiring brain surgery can cause further damage to the brain. $ressure on the brain can be harmful as it forces the brain against the skull, causing damage as

well as hampering the brain,s ability to function properly. "his drop in function can lead to longlasting brain damage or e'en death.

Procedure for a craniotomy

"he general procedure for craniotomy includes the following steps. "he hair on your scalp is sha'ed. .ou are gi'en a general anaesthetic.

.our head is placed on a round or horseshoe-shaped headrest so that the area where the brain in/ury is thought to lie is easily accessible. +f head mo'ement must be minimised, your head is clamped into place with a head pin fi%ing de'ice. "hrough preoperati'e imaging, the neurosurgeon determines the most appropriate site for the craniotomy. "he procedure begins by first cutting through the scalp. Small holes (burr holes) are drilled into the e%posed skull with an instrument called a perforator. An instrument called a craniotome is used to cut from one burr hole to the ne%t, creating a remo'able bone flap. "he membrane co'ering the brain is opened, usually as a flap. "he brain in/ury or disease is operated on 0 for e%ample, ruptured blood 'essels are repaired, or the blood clot or tumour is remo'ed. After the operation is finished, the piece of e%cised bone is replaced, the muscle and skin are stitched up and a drain is placed inside the brain to remo'e any e%cess blood left from the surgery. A craniotomy can take about two and a half hours.

Immediately after a craniotomy

After the operation, you can e%pect the following. .ou are monitored closely by hospital staff, probably in intensi'e care. "he breathing tube will remain in place until you ha'e fully reco'ered from the anaesthetic.

.our head is ele'ated to about 12 degrees to reduce the risk of intracranial (inside the skull) pressure. "he wound is co'ered with a soft dressing. .ou are gi'en pain medication as prescribed.

"he neurosurgeon tests regularly for any signs of brain damage 0 for e%ample, they may e%amine your pupils with a flashlight or ask you simple questions. .our eyes may be swollen and bruised. #epending on the type of brain surgery you had, you will need to take medications. Steroid medication (to control swelling) and anticon'ulsant medication (to pre'ent sei3ures) are commonly prescribed following craniotomy. .ou can e%pect to stay in hospital for between fi'e days and two weeks. "he length of stay depends on many factors, such as the type of surgery you had and whether or not you e%perienced complications or required further operations. Stitches (or staples) are usually remo'ed about one week after surgery.

Complications from a craniotomy

Some of the possible complications of surgery can include) Allergic reaction to the anaesthetic +n/ury from the head pin fi%ing de'ice

+n/ury to facial muscle +n/ury to the sinuses +nfection of the bone flap Sei3ures *leeding *rain damage *rain swelling Stroke.

Taking care of yourself at home

*e guided by your doctor, but general suggestions include) +f your doctor has prescribed medicines, make sure you take them strictly as directed. Alcohol could interact with your medications, so check with your doctor.

"here may be a depression in your skull where the bone flap was remo'ed. .our wound may ache for a few days after the operation. .ou may e%perience itching as the skin heals.

.ou may e%perience headaches for about two weeks. .our wound may ha'e a small pocket of fluid beneath it for a while. "his is normal and should disappear with time. "he skin on one side of your wound may feel numb for some months. E%pect to feel unusually tired 0 afternoon naps may help. .ou may return to work (for light duties only) after about si% weeks. 4eep in mind that you may ha'e to wait about three months before you can dri'e your car again. 5alking is a recommended form of e%ercise. .ou should wait at least three months before you return to gentle, non-contact sporting acti'ities. Contact sports should be a'oided for at least one year. $hysiotherapy, occupational therapy and speech therapy can help you manage any neurological problems like clumsiness and speech problems. 6sually, therapy is only needed if there were neurological problems before surgery. See your doctor immediately if you e%perience any signs of wound infection (such as redness or discharge), or if you ha'e any other unusual symptoms such as se'ere headache, sei3ures, 'omiting, confusion or chest pain.

Long-term outlook
.our reco'ery depends on 'arious factors, including) "he kind of brain in/ury you had 7ow se'ere the in/ury was

Complications of the in/ury "he presence or absence of neurological problems "he type of surgery you had Complications of the surgery Side effects or complications of postoperati'e treatments, such as radiotherapy .our age and general health, including other medical conditions you may ha'e.

Other forms of treatment

*rain surgery is generally the first line of treatment for brain in/uries and conditions. 7owe'er,

other forms of treatment may include, for e%ample, radiation therapy and chemotherapy in the case of brain cancer.

Where to get help

.our doctor 8eurologist 8eurosurgeon +n an emergency, always call triple 3ero (222)

Things to remem er

A craniotomy is an operation to open the skull (cranium) in order to access the brain for surgical repair. "here are many different types of brain surgery, but the reco'ery process following craniotomy is much the same. 9eco'ery depends on many factors, including the type and se'erity of brain in/ury, the type of surgery and whether or not there were neurological deficits before surgery.