Craniotomy – When Is It Considered For A Patient?

A craniotomy is a type of brain surgery. It involves removing a part of the skull, or cranium, to gain access to the brain. When your surgeon completes the surgery, they replace the bone.

Gurneet Sawhney Created on 11th Oct, 21

Many people in India require a craniotomy procedure. They visit a neurosurgeon in India to understand more about the procedure. Has your neurosurgeon suggested you a craniotomy procedure as well?

In this article, we will look at what craniotomy is and whendoes a patient require the procedure.


Let us begin by understanding what craniotomy is?


Craniotomy – what is it?

A craniotomy is a type of brain surgery. It involves removing a part of the skull, or cranium, to gain access to the brain. When your surgeon completes the surgery, they replace the bone.


A craniotomy is performed to remove brain tumors and treat aneurysms in general.


When does a person require craniotomy surgery?

A craniotomy is used to treat the following brain conditions:

  • Tumour
  • Aneurysm
  • Infection
  • Swelling(cerebral edema)
  • Internal bleeding in the skull
  • Blood clot
  • Brain abscess
  • Fractured skull
  • Tear in the dura mater
  • Arteriovenous malformation
  • Arteriovenous fistula
  • Intracranial pressure
  • Epilepsy

A craniotomy is also used to implant devices for movement disorders like Parkinson’s disease.


How is craniotomy performed?

A craniotomy usually involves the following:


(i) Before the surgery

You will have one or two preoperative appointments with your neurosurgeon to prepare for the operation.

They will use a range of checks to make sure you are fit for the treatment. This will most certainly contain the following:

  • Physical examination
  • Blood checks
  • Neurological examination
  • Brain imaging (CT or MRI)

Based on your medical history and the form of craniotomy, the surgeon will choose the surgical site.


You will fast (not eat) after midnight the night before your surgery. You will likely need to wash your hair with antiseptic shampoo as well. Depending on your condition, your surgeon may ask you to take some more steps before surgery.


(ii) During the surgery

You will take off all your clothes and jewellery when you arrive for surgery. You will be dressed in a hospital gown.

On the operating table, you will either sit or lay down. The position is determined by the region of the brain that is being operated on. Your head will be held in place by a head device.


Following that, the medical team will:

  • Place an intravenous line in your arm or hand.
  • Place a urinary catheter inside your bladder.
  • Administer general anesthesia to you

After the anesthesia has put you to sleep, your surgeon will remove the hair on the surgical site. They will even disinfect the region to avoid infection.


Your surgeon will incise your scalp. They will cut a piece of bone called a bone flap with a medical drill and saw.

Your surgeon would then sever the dura mater to gain access to the brain. The dura mater is the outermost membrane of the brain. Your surgeon will perform the surgery and, if required, take tissue samples.


After the treatment, the tissue will be stitched back together. Wires, stitches, or plates will be used to replace the bone flap. Finally, the surgeon will patch or staple the incision in the skin before applying a sterile bandage. The procedure could take up to 2 1/2 hours.


(iii) Recovery after surgery

The length of recovery is determined by the type of surgery performed. This is how it normally looks:


Immediately after surgery

When the surgery is over, you will be taken to the rehab unit or intensive care unit. As you wake up, nurses will check your vitals.


When your vital signs have stabilized, you will be taken to your hospital bed. You should expect to spend about a week in the hospital.


Your specialists will most likely do the following during your stay:

  • Elevate your head to reduce swelling
  • Give you oxygen for some days
  • Demonstrate deep breathing exercise to prevent pneumonia
  • You will wear compression stockings on your legs to avoid blood clots.
  • The urinary catheter will remain in your bladder for some days.

Your specialists will conduct neurological examinations regularly to ensure that your brain and body are in good working order.


Your surgeon will give you home-care instructions before you leave the hospital.


At home

Follow the doctor’s instructions for bathing and incision care after a craniotomy. Take your prescribed medicines as directed by your doctor.


You will not be able to work for at least 6 weeks. During this time, you can experience problems with:

  • Walking
  • Conversing
  • Stamina and strength
  • Balance

You might need physiotherapy, occupational therapy, or speech therapy to recover these functions. Also, you will need a lot of rest.


Keep all your follow-up appointments so your doctor can track your progress. They will inform you when you will be able to resume those activities.


What will it be like after a craniotomy surgery?

Look after yourself even after you have completely recovered. It will assist in the handling of future problems and boost the long-term outlook.


Keep your follow-up appointments with your doctor. It is also a good idea to:

  • Workout daily
  • Eat a well-balanced diet
  • Restrict or stop consuming alcohol
  • Give up cigars (It might not be easy, but a doctor can help create a plan that works for you)
  • Get plenty of rest

A craniotomy, like any other surgery, can result in complications. Your surgeon will form the most appropriate treatment plan to lower your risk.


For at-home treatment, follow your doctor’s instructions. If you have severe headaches, seizures, or signs of wound infection, call them right away.



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