What is a Craniotomy?

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  • Written By: Emma Lloyd
  • Edited By: Bronwyn Harris
  • Last Modified Date: 16 May 2020
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A craniotomy is a surgical procedure in which a cut is made in the cranium. This procedure involves creating a bone flap in the skull, through which the brain can be accessed. The craniotomy is carried out in conjunction with many types of brain surgery, including surgery to drain excess fluid from the skull, blood clot or tumor removal, surgery to repair an aneurysm, or a biopsy.

Generally a craniotomy is carried out by a neurosurgeon, who may or may not have training in skull surgery as well as brain surgery. The surgeon may also work with other surgeons, depending on the type of procedure being performed. For example, the neurosurgeon may work with an oculoplastic surgeon if the procedure involves the eyes as well as the skull or brain.

Up to several weeks prior to surgery, the patient will be briefed on preparatory procedures such as blood tests, x-rays, or other scans which they must undergo. In addition they may be required to stop taking certain types of medication, such as anti-inflammatories, and stop smoking or drinking alcohol prior to surgery. This is important because certain medications, as well as alcohol and nicotine, can cause blood thinning which may increase the risk of certain complications during and after surgery.

During a craniotomy, an incision is made in the scalp, after which skin and muscles are lifted to expose the skull. Small holes are drilled into the skull in an appropriate location, and a surgical saw is then used to cut a bone flap in the skull. Next, the bone flap is removed to expose the brain. The neurosurgeon will then operate to correct the problem that has prompted the surgery, such as tumor removal or fluid drainage. When this procedure is completed, the bone flap is replaced, and may be fixed into place using titanium screws and plates. The incision is then closed and dressed.

Following a craniotomy procedure, patients must usually manage pain using prescription narcotics, for up to four weeks. This medication can cause constipation; therefore plenty of water and high fiber foods should be included in the diet. After this time, pain can generally be managed with over-the-counter medications. In addition, patients should refrain from driving, heavy lifting, strenuous activity, and alcohol, until these activities are deemed safe by their surgeon or physician. Patients who experience symptoms such as high fever, an infected incision site, drowsiness, limb weakness, severe neck pain, or vomiting, should seek immediate medical attention.

The results of this procedure are dependent on the type of medical condition which is being treated. Typically, recovery times may range from between one and four weeks, for a person who is otherwise in good physical health. The specific risks of this procedure include seizures, stroke, brain swelling, nerve damage, or brain damage; however the risk of these complications is generally very low.

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