Elective Craniotomy

During a craniotomy, a flap of the skull is removed to access the brain. This surgical procedure is performed on patients with brain lesions, traumatic brain injuries, and other cerebrovascular diseases.

What is it?

When a patient requires treatment on their brain that cannot be done with minimally invasive alternatives, a craniotomy is performed.  A craniotomy removes a portion of the skull to expose a region of the brain.  The procedure is recommended for various conditions including brain tumors, hematomas, aneurysms, skull fractures, foreign objects (such as a bullet), and infections.  There are also many different names for craniotomies, usually referring to the region of the brain the bone flap is covering.  During a craniotomy, the bone flap is replaced following the treatment.  A craniectomy removes the bone and does not replace it.

What should I do to prepare?

Prior to the procedure, you will need to have a CT Scan or MRI along with various other diagnostic tests.  Your doctor may also suggest donating blood weeks before surgery.  Blood thinners or NSAID medications cannot be taken at least one week prior to the procedure. Other medications may be prescribed. Stop smoking as soon as you can before the procedure; smoking reduces the body’s ability to heal properly.  You may also be given a special shampoo to use before surgery.  Directly before the procedure, part of your scalp will be shaved.

What happens during the process?

Patients will be given general anesthesia for this procedure.  When the patient is sedated, their head will be fixed to a clamp device that will hold the skull in position during the surgery.  An incision is then made in the skin in order to peel back the muscle.  A small hole is drilled into the skull, and a specialized saw is inserted to cut away the intended bone.  After the bone is cut away and the brain is exposed, the surgeons can work to correct the problem within the skull.  This entire surgery may take anywhere from 3-5 hours or even more depending on the particular procedure.  After the surgeons have finished operating within the skull, the bone flap is returned and reinforced with metal plates, holding it in place.  These plates will mostly likely be permanent to give support continuously to that area of the skull.  The muscles and skin are then sutured together over the bone.

What happens during the process?

Craniotomies are invasive procedures involving the brain.  This will increase the severity of possible risks and complications.  Some of the associated risks and complications are swelling of the brain, stroke, seizures, infection and excessive bleeding, blood clots, memory problems, difficulty with speech, permanent nerve/brain damage, coma, and paralysis.


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