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craniotomy

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Brain hemorrhage

Alternative Names
brain surgery

Definition
A craniotomy is a type of surgery done to open part of the cranium, or skull. This procedure is needed when a person has a disease or injury that affects the brain, its tissues, or its blood vessels.

Who is a candidate for the procedure?
A craniotomy allows the surgeon to:
  • remove a lesion, such as a brain tumour
  • remove a blood clot, such as a chronic subdural haematoma
  • repair a leaking blood vessel, known as a cerebral aneurysm
  • remove an abnormal collection of blood vessel, known as arterio-venous malformation or AVM
  • drain a brain abscess, or pocket of pus
  • repair skull fractures caused by a head injury
  • repair a tear in the membrane lining the brain
  • relieve increased intracranial pressure, which is the pressure within the brain
How is the procedure performed?
A craniotomy is performed under general anaesthesia. This means the person is put to sleep with medication and cannot feel any pain. The hair on part or all of the scalp is shaved. An incision is made in the scalp over the area of the suspected condition or disorder. A flap of the bone is cut away from the skull and set aside during the surgery. The disorder is located and treated. The bone flap is replaced and the scalp is closed with sutures or clips.

What happens right after the procedure?
After the procedure, the person will be taken to the surgery recovery room or an intensive care unit. An endotracheal tube, or breathing tube, may be left in place for a short time until the effects of the anaesthesia have worn off.

Since there is some risk involved with this surgery, a doctor will check vital signs often. To do this, the doctor will:
  • check the reaction of the person's pupil with a flashlight
  • ask the person simple questions to determine his or her mental status. For instance, the person may be asked his or her name, the date, and where they are.
  • evaluate movement in the person's arms and legs
A turban-like dressing or soft adhesive dressing will be placed over the incision. Analgesia will be given as needed.

What happens later at home?
Most people need to stay in the hospital between 5 and 14 days after a craniotomy. Depending on the area of the brain affected, the person may need physiotherapy, occupational therapy, and speech therapy to regain normal function. If surgery was performed for a brain tumour, radiation therapy or chemotherapy may be needed. Activity is slowly advanced. It is common for people to feel tired 6 weeks after surgery.

What are the potential complications after the procedure?
There can be problems following any surgery, such as bleeding, infection, and allergic reactions to anaesthesia. Potential complications following a craniotomy include: Author: Gail Hendrickson, RN, BS
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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