Craniotomy
A craniotomy is a procedure in which a portion of the skull is removed to allow surgery on the brain.
- Purpose: A craniotomy is required whenever surgery on the brain or associated structures is performed. This may include removal of a brain tumour or blood clot, repair of an aneurysm or brain trauma or relief of pressure on the brain.
- Pre-operative preparation: Patients will usually need medical tests and scans and may need to stop taking some of their medications and fast from food or fluids for a specified period of time before the surgery.
- Anaesthesia: A craniotomy is generally performed under general anaesthesia – meaning the patient will be asleep during the procedure. In specialised circumstances, brain surgery can be done under local anaesthesia with sedation (awake craniotomy) to test brain function during the surgery.
- Procedure: The skull is opened using a drill, and the coverings of the brain are cut open to expose the brain. The details of the specific procedure depend on the reason for the craniotomy. After the procedure is complete, the skull bone is put back using metal plates and screws or wire mesh.
- Recovery: Most patients can go home 48hours after a craniotomy, although the exact time depends on the reason for the surgery. Mild pain, swelling, and headaches are common after a craniotomy, and may require pain medications. Full recovery may take several months, and some patients may need physiotherapy and other rehabilitation to regain normal function. It is the law that patients cannot drive for AT LEAST 3 months after a craniotomy.
Risks of craniotomy
A craniotomy is a procedure in which a portion of the skull is removed to allow surgery on the brain. As with any surgery, there are risks associated with a craniotomy, including infection, bleeding, and complications from the anaesthetic. Some patients may develop neurological symptoms such as changes in cognitive function (thinking), movement, speech or vision, although these effects are often temporary.
- Bleeding: Whenever tissue is cut, bleeding can occur. Bleeding in the brain can be serious but is uncommon.
- Infection: Whenever tissue is cut, infection can occur. Infection in the brain can be serious but is uncommon.
- Brain swelling: The brain may swell after a craniotomy, leading to pressure in the skull and on the brain.
- Neurological damage: The structures on the brain that control cognitive function (thinking), movement, speech or vision may be damaged during a craniotomy. The risk depends on the location and purpose of the craniotomy.
- Seizures: Seizures may occur after a craniotomy but are uncommon.
- Stroke: There is a very small risk of stroke during or after a craniotomy.
- CSF leak: The fluid around the brain (cerebrospinal fluid (CSF)) may leak through the skin, nose, or ear after a craniotomy, which can lead to infection (meningitis). This is uncommon.
- Anaesthesia risks: As with any surgery requiring anaesthesia, there are risks, including allergic reactions, breathing problems, and heart problems.
- Long-term effects: In some cases, there may be long-term neurological effects from a craniotomy, such as changes in cognitive function (thinking), memory, personality, movement, speech or vision.
It’s important to discuss the potential risks and benefits of a craniotomy with your doctor to make an informed decision about treatment. Regular follow-up care is also important to monitor progress and change the treatment plan if necessary.