Why get a craniotomy

Thus, a craniotomy is usually the first step of brain surgery. Craniotomies can be performed to reach a brain tumor, clip or repair an aneurysm, remove an arteriovenous malformation , drain a pus-filled pocket abscess within the brain, and more.

Craniotomies are named on the basis of their location and corresponding bones or anatomic landmarks. The exact location of the skin incision and how much bone will be removed should be discussed with your neurosurgeon. In an awake craniotomy, the patient is woken up during one part of the brain surgery. When the surgeon begins operating near areas that are critical for speech, the patient is awakened to help the surgeon map which areas should be preserved to maintain normal speech function.

This can be done by simply having a conversation with the neurosurgeon and anesthesiologist while the surgery is taking place. This is not a very painful procedure, because brain tissue itself cannot feel pain. Figure 2. Craniotomies are named on the basis of their corresponding bones or anatomical landmarks. Incision lines are drawn. From top to bottom and left to right, the craniotomies are named as pterional or frontotemporal , parietal, supraorbital, subtemporal, occipital, parasagittal, interhemispheric, and bifrontal.

An even larger piece of bone can be removed to relieve pressure on the brain. Unlike a craniotomy, a craniectomy does not reattach the bone immediately after the procedure. The bone flap is kept clean and frozen for future use when repairing the bone cranioplasty , usually 6 weeks after the craniectomy.

As with a craniotomy, there are different types of craniectomies, depending on the level of decompression needed.

However, the incision for a decompressive craniectomy is generally larger than that of a craniotomy. Figure 3. Decompressive craniectomies are generally larger than craniotomies. The green line represents an appropriately large incision to relieve pressure on the brain, whereas an incision on the red line would be too restrictive.

A craniotomy is performed by a neurosurgeon, who might work with a team of otolaryngologists, plastic and reconstructive surgeons, anesthesiologists, critical care experts, interventional radiologists, oncologists, and rehabilitation experts, depending on the underlying condition being treated. Before a craniotomy, the surgeon will explain what the procedure will involve and its risks and benefits. Consent forms and other paperwork will be completed to inform the surgeon of relevant medical history such as allergies, other medications you are taking, reactions to anesthesia, and any previous surgeries.

One week before surgery, nonsteroidal anti-inflammatory drugs NSAIDs such as ibuprofen for example, Advil or Motrin , naproxen for example, Aleve , and other prescribed NSAIDs, as well as blood thinners such as warfarin for example, Jantoven, Coumadin , acetylsalicylic acid aspirin , and clopidogrel for example, Plavix should be stopped to decrease the risk of bleeding.

This list is not all-inclusive. Inform your physician of all medications and supplements you are taking, and follow his or her recommendations. Several days before surgery, a physical exam, blood tests, an electrocardiogram ECG , chest X-rays, and other tests might be performed to ensure that your body can safely undergo anesthesia and handle the surgery and that surgical scenarios for example, bleeding are properly prepared for.

A baseline neurological exam is conducted and repeated after surgery. MRI might be scheduled if the surgeon plans to use image guidance during the operation. On the night before or morning of the surgery, your physician might ask that you fast not eat or drink anything to prevent vomiting while under general anesthesia.

To reduce the possibility of infection at the site of incision, showering or washing your hair with a special antiseptic shampoo might be required. A craniotomy can take 1 to 2 hours to perform, and then it takes an additional 3 to 5 hours or longer for the actual treatment procedure for example, brain tumor removal , depending on your underlying condition.

The patient is placed on the operating table and given general anesthesia. After the patient is asleep, a breathing tube is placed into the lungs intubation and connected to a ventilator that mechanically pumps oxygen during the operation.

A line is drawn on the scalp to mark the path of the initial incision. Figure 4. The skin around the incision line is scrubbed with an antiseptic to reduce the possibility of infection. Clips are applied to the edges of the cut to minimize bleeding. Figure 5. The scalp is cut, and clips are placed on the edges to minimize bleeding.

As the incision approaches muscle, a blunt tool is inserted over the muscle to protect any arteries. Muscles, if present, are flapped back and secured. A small opening in the skull burr hole is made with a surgical drill called a perforator. A blunt-ended tool is inserted into the burr hole and used to separate the outer covering of the brain dura away from the inner part of the skull bone.

Another instrument called a craniotome is then used to saw through the bone from the initial burr hole to create a removable bone flap. Figure 6. Left A blunt dissector is placed through the burr hole and swept under the bone to separate the dura from the bone. Right A craniotome with a footplate is used to saw through the bone and create the bone flap. The dura is cut open and flapped back. It might be temporarily secured to the muscle with stitches. There is a similar procedure known as a craniectomy, in which the skull fragment — also known as a bone flap — is left out until the swelling in brain has gone down, at which point it is secured back in place during a second operation.

Like any other type of brain cancer surgery, a craniotomy has several risks. These include:. Most people who have a craniotomy do not experience any major complications.

Those who work with an experienced brain surgeon also tend to have the best outcomes, as surgeons who perform these complex procedures on a regular basis tend to have the most highly refined techniques.

Moffitt surgeons perform brain cancer surgeries using precision techniques and innovative approaches. For instance, to avoid damaging the tissues that control speech and fine motor function, our surgeons can wake the patient up for a portion of the surgery and have them respond to certain prompts.

This is known as an awake craniotomy. Most patients are instructed to avoid engaging in strenuous activities, consuming alcohol and tobacco products and driving until cleared for these activities by their treatment team. We do so by not only using the newest and most effective brain surgery techniques, but also by providing comprehensive supportive care services throughout the recovery process.

It causes hearing loss and balance issues. Removing the semicircular canals results in hearing loss. However, the surgery decreases the risk of facial nerve damage.

A bifrontal craniotomy, or extended bifrontal craniotomy, is done to remove difficult tumors in front of the brain. Your surgeon makes a cut behind your front hairline. They remove a piece of the bone that forms the curve of your forehead, letting them access the front of your brain. In craniotomy, the bone is replaced at the end of the surgery. On other hand, in a craniectomy , part of your skull is removed. Sometimes, the bone is replaced in a second surgery. Your risk of complications depends on many factors, including your specific brain surgery and medical condition.

Nurses will monitor your vitals as you wake up. You can expect to stay at the hospital for about 1 week. Your healthcare team will frequently do neurological checkups to ensure your brain and body are functioning properly. Take your prescription medication as directed. To regain these functions, you may need physiotherapy , occupational therapy, or speech therapy. This will help manage future complications and improve your long-term outlook.

In a craniotomy, your surgeon temporarily removes a piece of your skull and operates on parts of your brain. They might do this to remove a tumor or treat an aneurysm, among other reasons. Like all surgeries, a craniotomy can cause complications. Your surgeon will create the best treatment plan to reduce your risk. Contact them immediately if you experience severe headaches, seizures, or signs of a wound infection. Burr hole surgery is a serious procedure performed under the supervision of a neurosurgeon.

A craniectomy is a surgery that removes part of your skull. An year-old man was discovered to have empty space where part of his brain should be. Double jaw surgery involves both jaws.

Here's what you need to know. Neck conditions such as pinched nerves, spinal cord compression, and neck…. Anthropophobia is a fear of people.