The brain is vulnerable to bleeding, contagion, trauma and other shape of damage. This damage or alteration in brain function sometimes needs brain surgery to diagnose or treat these problems. A craniotomy is an operation to open the head in order to access the brain for surgical repair. There are many different types of brain surgery, but the recovery process following craniotomy is much the same in most cases.
Conditions requiring Craniotomy
Some of the conditions that need craniotomy and surgical repair include:
- Brain cancers
- Cerebral oedema (swelling of the brain)
- Bleeding within the skull.
The universal procedure for craniotomy includes the following steps.
- The hair on your scalp is shaved.
- You are given a general anaesthetic.
- Your head is placed on a round or horseshoe-shaped headrest so that the area where the brain injury is thought to lie is easily accessible. If head movement must be minimized, your head is clamped into place with a head pin fixing device.
- Through preoperative imaging, the neurosurgeon determines the most appropriate site for the craniotomy. The procedure begins by first cutting through the scalp.
- Small holes (burr holes) are drilled into the exposed skull with an instrument called a perforator.
- An instrument called a craniotomy is used to cut from one burr hole to the next, creating a removable bone flap.
- The membrane covering the brain is opened, usually as a flap.
- The brain injury or disease is operated on - for example, ruptured blood vessels are repaired, or the blood clot or tumor is removed.
- After the operation is finished, the piece of excised bone is replaced, the muscle and skin are stitched up and a drain is placed inside the brain to remove any excess blood left from the surgery.
- A craniotomy can take about two and a half hours.
After the operation
You can expect the following.
- You are monitored closely by hospital staff, probably in concentrated care.
- The breathing tube will remain in place until you have fully recovered from the anaesthetic.
- Your head is elevated to about 30 degrees to reduce the risk of intracranial stress.
- The wound is covered with a soft dressing.
- You are given pain medication as prescribed.
- The neurosurgeon tests regularly for any signs of brain damage - for example, they may examine your pupils with a flashlight or ask you simple questions.
- Your eyes may be swollen and bruised.
- Depending on the type of brain surgery you had, you will need to take medications. Steroid medication and anticonvulsant medication are commonly prescribed following craniotomy.
- You can expect to stay in hospital for between five days and two weeks. The length of stay depends on many factors, such as the type of surgery you had and whether or not you experienced complications or required further operations.
- Stitches are usually removed about one week after surgery.
Side effects and complications
Some of the side effects and complications of surgery can include:
- Allergic reaction to the anaesthetic
- Injury from the head pin fixing device
- Injury to facial muscle
- Injury to the sinuses
- Infection of the bone flap
- Brain damage
- Brain swelling
Other forms of treatment
Brain surgery is generally the first line of treatment for brain injuries and conditions. However, other forms of treatment may include, for example, radiation therapy and chemotherapy in the case of brain cancer.