A craniotomy is a surgical procedure in which a piece of the skull is removed so the surgeon may access the brain beneath, for the treatment of a variety of neurological disorders.
What Is A Craniotomy?
A craniotomy is a surgical procedure in which a piece of the skull is removed so the surgeon may access the brain beneath. The cut-away portion – called the bone flap – may be small or large, and is typically put back in place after surgery on the brain is finished the incision closed.
Why Do I Need This Procedure?
A craniotomy may be required for the surgical treatment of a variety of neurological/brain disorders, including:
- Hematoma (blood clot)
- Aneurysm (blood vessel rupture)
- AVM (blood vessel disorder)
- Skull fracture
- Foreign object removal
In addition to providing access to the brain, a craniotomy also allows a surgeon to inspect the brain for abnormalities, perform a biopsy or relieve pressure inside the skull.
How Is A Craniotomy Performed?
A craniotomy may involve the removal of a small or large section of your skull. Although the procedure varies from patient to patient, depending on the condition to be treated and the specific needs of the patient and surgeon, the steps involved typically include:
- After your hair is shaved, you’ll be sedated under general anesthesia.
- After you’re asleep, your head will be secured in place with pins to a skull fixation device attached to the operating table.
- Based on your preoperative diagnostic imaging exams, your surgeon will make an incision in the skin and muscle over the part of the skull to be removed.
- The flap of skin and muscles are lifted up and pulled back to expose the skull.
- Small holes, called burr holes, are cut into the skull with a drill, to serve as an outline for the bone flap. (Some procedures may be performed through these small holes using computer guided imaging systems and small cameras called endoscopes, a type of surgery called minimally invasive surgery.)
- Using a special saw called a craniotome, your surgeon will cut between the burr holes to create a bone flap.
- The bone flap is removed to expose the protective membrane of the brain, called the dura.
- After making an incision in the dura, your surgeon folds the dura back to expose the brain, securing it with retractors.
- Your surgeon performs the brain surgery required.
- The retractors are removed and the dura closed with sutures.
- The bone flap is replaced and secured with plates and screws, which remain permanently to provide support.
- The muscles and skin are replaced and sutured; a drain may be inserted to prevent fluid retention.
- A soft adhesive bandage is placed over the incision.
After your procedure, you’ll be taken to the recovery room, where your vital signs will be monitored as you awaken from the anesthesia. Depending on the type of surgery performed, you may be given steroid medication (to control swelling) and anticonvulsant medication (to prevent seizures). Narcotic pain medication also may be prescribed for a limited time period for pain.
How Long Will It Take Me To Recover?
Your hospital stay may range from several days to several weeks, depending on the procedure and how well your recovery is progressing. Full recovery may take up to 8 weeks, depending on the underlying condition and your general health.
Please contact your doctor if you experience any of the following:
- A temperature that exceeds 101 degrees.
- Signs of infection at the incision site, such as redness, swelling, pain or drainage.
- Drowsiness, balance problems or rashes, if taking an anticonvulsant.
- Decreased alertness, increased drowsiness or weakness in the arms or legs.
- Headaches and/or vomiting.
- Severe neck pain.
Are There Any Risks Involved?
All treatment and outcome results are specific to the individual patient. Results may vary. Complications such as infection, nerve damage, blood clots, blood loss and bowel and bladder problems, along with complications associated with anesthesia, are some of the potential risks of spinal surgery.
Complications associated with a craniotomy may include:
- Brain swelling, which may require another craniotomy
- Nerve damage, resulting in muscle weakness or paralysis
- Cerebrospinal fluid leak
- Mental impairment
- Permanent brain damage and associated disabilities
Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information.