Munson Health
 
Craniotomy

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by Kellicker PG
 

Reasons for Procedure

The type of procedure depends on the reason it is being done. The most common reasons for a craniotomy include:
  • Biopsy
  • Brain cancer
  • Head trauma
  • Blood clot in the brain
  • Blood vessel problems with the brain
  • Nerve disorders
  • Brain swelling
  • Brain infection
  • Hydrocephalus treatment—insertion of a ventriculoperitoneal shunt which allows excess cerebrospinal fluid to drain into another area, usually the abdomen
Smoking may increase the risk of complications.
 

What to Expect

Prior to Procedure

Your doctor may do the following before your procedure:
Before surgery, you will need to:
  • Arrange for a ride home.
  • Arrange for help at home while you recover.
  • Talk to your doctor about any medications, herbs, or supplements you are taking.
You may need to stop taking some medications up to one week before the procedure. Medications that may need to be stopped may include:
  • Anti-inflammatory drugs
  • Blood thinners
  • Antiplatelets
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.

Anesthesia

  • General anesthesia—Used for most craniotomies. You will be asleep during the surgery.
  • Local anethesia—Used for stereotactic craniotomies. This blocks around the surgical site from pain, but you will still be awake.
General anesthesia is used to start awake craniotomies. Once the brain is exposed, the effects of anesthesia are slowly reversed. This is done so you can interact with the surgeons during the procedure. This helps them map the brain and determine which parts of the brain are critical for functioning.

Description of Procedure

Your head will be shaved and your skin will be washed with an antiseptic. The surgeon will cut into part of your scalp. Next, part of your skull will be removed and your brain covering will be opened. Depending on the reason for your surgery, several things may happen: a tumor may be removed, a part of your brain tissue may be taken, a tube may be placed, or repairs to your brain or its vessels may be done. The brain opening will then be sewn back into place and your skull replaced. Staples or stitches will be used to close the incision. A drain may be inserted to remove blood and fluid for the first few days after surgery. A dressing will be wrapped around your head.

How Long Will It Take?

Several hours, depending on the type and reason for surgery

How Much Will It Hurt?

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

Average Hospital Stay

The usual length of stay is 3-7 days. It is possible that you may have to stay longer if complications arise.

Post-procedure Care

At the Hospital
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, breathing, and mental status will be monitored.
You may be given the following medications to prevent:
  • Pain
  • Infection
  • Blood clots
  • Seizures
The staff will take measures to prevent pressure build-up in your brain.
You will be asked to get out of bed and walk around to prevent complications like blood clots or pneumonia.
At Home
When you return home, take these steps:
  • Follow your doctor’s instructions on cleaning the incision site.
  • Keep your incision clean and dry.
  • Ask your doctor when it is safe to shower, bathe, or soak in water.
  • Continue with your physical therapist’s exercise program.
If you feel symptoms of depression for more than two weeks, consider talking to a therapist or psychologist.
 

Call Your Doctor

Call your doctor if any of these occur:
If you think you have an emergency, call for medical help right away.
 

RESOURCES

American Brain Tumor Association
http://www.abta.org

National Brain Tumor Society
http://www.braintumor.org

 

CANADIAN RESOURCES

Brain Tumor Foundation of Canada
http://www.braintumour.ca

Canadian Cancer Society
http://www.cancer.ca

 

References


Awake craniotomy treatment. University of Miami Health System website. Available at: http://neurosurgery.med.miami.edu/clinical-subspecialties/brain-tumors/awake-craniotomy-treatment1. Accessed December 3, 2013.


Brain tumor information. National Brain Tumor Society website. Available at: http://www.braintumor.org/brain-tumor-information. Accessed December 3, 2013.


Guide to the care of the patient with craniotomy post-brain tumor resection. American Association of Neurological Nurses website. Available at: http://www.aann.org/pdf/cpg/aanncraniotomy.pdf . Accessed December 3, 2013.


Hydrocephalus in children. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated February 11, 2013. Accessed December 3, 2013.


Professional Guide to Diseases. 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.


What is a craniotomy? Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/neurology%5Fneurosurgery/specialty%5Fareas/brain%5Ftumor/treatment/surgery/craniotomy.html. Accessed December 3, 2013.


6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

 

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