A craniotomy is a surgical procedure to allow access the brain for surgical repair. Like any other part of the body, the brain is susceptible to bleeding, infection, trauma and other forms of damage. These problems can lead to a change in brain function which might require brain surgery to diagnose and treat.
Some of the conditions that require craniotomy and surgical repair include:
- brain cancers
- infections
- abscesses
- cerebral oedema (swelling of the brain)
- bleeding within the skull
During the Surgery
After you are asleep, your hair will be shaved, but only as much as needed for the craniotomy surgery.
The neurosurgeon will open the scalp and then the skull. In order to open the skull, small holes are drilled so the bone between the holes can be cut and lifted off. Once the affected area of the brain is surgically repaired (or tumor is removed), the bone flap is replaced using titanium plates and screws that usually require no further attention. The scalp will be closed with stitches, staples, skin glue or steri-strips based on the size of the incision.
A dressing is applied and usually remains in place for the first 24-48 hours after surgery. Once you are stable, you will be moved to the intensive care unit.
After the Surgery
The length of craniotomy recovery time in the Neuro ICU will depend on the reason you had a craniotomy and how you are recovering after surgery. In the ICU, you will be closely monitored by the nursing staff. Your vital signs (blood pressure, heart and respiratory rates and temperature) as well as neurologic exam will be performed every 1-2 hours.
You will have a gauze dressing on your head. To find out if you are having an large amount of swelling, you will be asked frequently to squeeze the hand of the nurse and wiggle your toes. The nurse will be checking your pupils in your eyes to see if they get smaller when a flashlight is shined into your eyes. Also the nurse will ask you questions to see if you are aware of who you are and where you are and what is the month and year. Sometimes the questions may include who is the president of the United States or what is your address. You will go to a special care unit after surgery.
You may have a breathing tube and remain on a ventilator for a period of time. As soon as it is medically possible, the breathing tube will be removed. If you are not on a breathing tube, you will be asked to do breathing exercises regularly to keep your lungs fully inflated.
You will be up and out of bed as soon as your doctor says it is allowed. In many cases, you will be up the evening of your surgery or the next morning. An eating regime will be started as soon as medically possible. But first, we have to make sure that you are awake enough and that surgery has not affected your ability to swallow.
You will be moved out of the ICU and into a bed on the Neuroscience Unit as soon as your surgeon feels that you are stable enough to transfer.