Craniotomy

A Comprehensive Guide On Craniotomy

The brain is a complex organ that controls various functions, such as thought, memory, vision, hunger, and almost every process that regulates the body. 

Some patients can have abnormal cell growth or bleeding in the brain. In such cases, neurosurgeons recommend Craniotomy.

It is a surgery that involves cutting and removing a part of the skull bone to access the brain. 

The Neurosurgeon uses specialized tools during this surgery. Here, the bone flap is removed and replaced at the end of surgery. The Neurosurgeon uses MRI and CT scans to access the exact location of the brain where tumors or leaked blood vessels are present. 

What Is Craniotomy?

A craniotomy is a type of brain surgery in which the Neurosurgeon will remove a part of your brain skull (bone flap) to access the affected site in the brain completely. The Neurosurgeon usually performs this surgery to treat different brain diseases or injuries.

The skull is the hard protective covering of the brain. There are three layers of tissues called meninges just inside your skull. The first and thickest layer is known as the Dura mater. It is then followed by the Arachnoid mater and pia mater. There is a subarachnoid space between the arachnoid mater and the pia mater. It contains blood vessels and a fluid known as cerebrospinal fluid. 

Intracranial pressure is the pressure inside the skull exerted by cerebrospinal fluid, brain tissue, or blood vessels. The pressure can get increase because of tumors, head injuries, or blood vessel issues. It can cause swelling inside the brain or change the skull's shape, which can further lead to severe brain injuries. In such cases, the Neurosurgeon recommends the Craniotomy procedure.

This procedure helps to remove abnormal brain tissue, excess cerebrospinal fluid, or blood clots from your brain.

The craniotomy procedure is usually performed by a Neurosurgeon. He may work with a team of otolaryngologists, critical care experts, oncologists, rehabilitation experts, and others.

Types Of Craniotomy

1. Translabyrinthine Surgery

Here, the surgeon makes a cut behind the ear to remove the acoustic neuroma. It is a noncancerous tumor that grows on the nerve connecting the ear to the brain.

Your surgeon will remove the mastoid bone and some inner ear bone to access the tumors. He carefully removes the tumors without damaging the brain.

This procedure has a high success rate and less chance of damaging the facial nerve. However, it can result in incomplete hearing problems in the affected ear.

2.Orbitozygomatic Craniotomy

Here, the surgeon will cut the hairline and remove bone from the cheek and orbit. The procedure allows surgeons to have deep access to the brain.

3. Retrosigmoid Or Keyhole Craniotomy

This procedure involves a cut behind the ear to access skull base tumors. Your Neurosurgeon will do this procedure especially to remove certain tumors like meningiomas, acoustic neuromas, or metastatic brain tumors. A patient will have less pain compared to an open craniotomy procedure.

4. Minimally Invasive Supra Orbital Craniotomy

Here, the surgeon makes a small incision on the eyebrow to access the tumors present in the brain or around the pituitary gland. It is a minimally invasive surgery and hence involves less pain and complications compared to an open craniotomy procedure.

5. Extended Bifrontal Craniotomy

This procedure targets the removal of tumors present on the front of your brain. Here, the surgeon makes an incision behind the hairline and then removes the bones. He will replace the bone at the end of the surgery.

What Is The Difference Between Craniotomy And Craniectomy?

Most people are confused between Craniotomy and craniectomy. The bone flap is removed during the craniotomy procedure. But it is reattached again to its original location by screws and metal plates at the end of surgery.

The craniectomy procedure is slightly different. The Neurosurgeon will remove the skull bone in this case but will not attach immediately. It is followed by another surgery known as cranioplasty to replace the missed skull bone.

Why Do You Need Craniotomy?

Your healthcare provider may recommend a craniotomy procedure when you are diagnosed with the following conditions.

• Treating hydrocephalus
• Treating brain tumors
• Repairing skull fractures
• Removing blood clots from the blood vessel
• Remove arteriovenous malformation
• Treat epilepsy
• Repairing tears in the membrane lining of the brain
• Draining pus
• Implanting stimulator devices for treating Parkinson's disease or dystonia.
• Swelling in the brain

Risks Of The Craniotomy Procedure

Below, we list a few risks associated with craniotomy surgery.

• Infection
• Blood clot
• Muscle weakness
• Brain swelling
• Unstable blood pressure
• Seizures
• Leakage of cerebrospinal fluid.
• Pneumonia(Lungs infection)
• Risks associated with general anesthesia.

There are even chances of other complications like memory problems, paralysis, coma, or speech problems, but these are very rare.

What Happens Before The Craniotomy Procedure?

Your healthcare provider will explain the surgery procedure and its associated risks. He may ask about your medical history and perform specific tests to ensure your body is fully prepared for the surgery. 

The tests may include blood tests, electrocardiograms, chest X-rays, etc. Your doctor may also perform a neurological exam and keep the report to compare after the surgery.

You should inform your doctor if you take over-the-counter drugs, herbal supplements, or prescribed medicines. Tell your doctor clearly if you are allergic to certain medications.

Remember, if you are pregnant or suffering from any disease, then discuss it with your doctor. You should stop smoking many days before the surgery. It can positively impact your surgical procedure, and you will recover earlier.

You should stop taking nonsteroidal anti-inflammatory drugs like ibuprofen and blood thinners like warfarin seven days before the surgery to decrease bleeding risks.

Your surgeon may ask you to wash your hair with antiseptic shampoo just before the surgery date. You will not be allowed to eat and drink on the night before the surgery to prevent vomiting.

What Happens During The Craniotomy Procedure?

The craniotomy procedure requires a hospital stay of 5-7 days. You may go to a rehabilitation center for a few days after remaining in the hospital.

Before the surgical procedure, the nurse will tell you to remove clothes, jewellery, or other objects and have to wear the hospital gown. The nurse will insert one intravenous line into your arm. A urinary catheter will also be inserted to drain urine quickly.

You will be then asked to lie on the operating table and will be given general anaesthesia so that you will not feel the pain during the surgery. 

The anaesthesia specialist will consistently monitor your heart rate, breathing, and blood pressure. A breathing tube is inserted into your trachea when you start falling asleep. It is then connected to the ventilator to pump consistent oxygen to the lungs.

The nurse will shave the area of your head that needs to be operated on and then use an antiseptic solution to clean it. The antiseptic solution will prevent infection during the surgery. Your head will be either on a cushion or held by a device.

The Neurosurgeon will then cut the affected area. The area may differ from one patient to another depending upon the brain injuries, tumor, or type of craniotomy surgery. 

The Neurosurgeon will make one or more holes in the skull using a medical drill. He will then connect these holes to create a circular piece of bone called a bone flap. It is carefully cut by a special saw and kept aside. It is replaced at the end of the surgery.

Now, your Neurosurgeon will cut the dura mater to expose the brain. He removes the tumor. The doctor removes the excess cerebrospinal fluid if required. If needed, he may use microsurgical tools or a high-power microscope to magnify the affected area. The surgeon will then close the dura mater incision with sutures. The Neurosurgeon will then attach the bone flap with the help of small metal plates and screws, and that will remain with you for your entire life.

The skull contains delicate blood vessels and nerves, which can be damaged during surgery. Therefore, the surgeon may use advanced technologies during the surgery. The Neurosurgeon will put a sterile bandage over the incision site at the end of the surgery.

After The Procedure

You will be immediately shifted to the ICU after the surgical procedure. You will be closely monitored, and the nurse may give you some medication to reduce brain swelling. 

The recovery process varies depending on the type of craniotomy procedure. A neurological exam will be conducted from time to time to ensure there is no bleeding, seizures, or any other complications.

You will be shifted to the general room once your heart rate, blood pressure, and breathing become absolutely stable. Some patients may require oxygen even after the surgery. However, the problem goes away after a few days or when you return home.

You may have pain at the surgical site. Your doctor will prescribe pain relief medications, such as narcotics and muscle relaxants, to get relief from pain.

Your nurse may teach you some deep breathing exercises to prevent infection in your lungs. Your nurse may tell you to move your arms or legs to assess your brain function. 

The hospital staff may check your pupil and ask some basic questions like name and date of birth to ensure that your brain is working properly. Your head may be kept in an elevated position to reduce swelling.

You will first be allowed to make some movements on your bed. Later, you will be allowed to walk or stand slightly with assistance from the nurse.

You will be given liquids to drink just for a few hours after the surgery, but gradually, you will switch to a solid diet.

The urinary catheter will be removed once you start moving out of your bed. If you notice burning or changes in your urination, inform your doctor immediately, as that can be a sign of infection.

You may be shifted to a rehabilitation center for a certain period of time to regain strength. At the time of discharge, your doctor will also provide homecare instructions.

At Home

You should keep your incision site extremely neat and clean. Your surgeon will give you bathing instructions while you are discharged from the hospital, and you need to follow them at home.

You may feel pain at the incision site during coughing or breathing. Take pain relief medications as recommended by your doctor.

If you have stitches or staples, they will be removed during your next follow-up. If your doctor has used adhesive strips, that will automatically fall off. Don't take blood-thinning medicine or any other medications on your own. You should always consult your doctor and then take medications. 

Continue breathing exercises even in your home to avoid lung infections. Avoid exposure to smoke, fumes, or environmental pollution as much as possible.

It's best to wear a loose turban over the incision site. Do not drive immediately after the surgery; only after asking your doctor. Again, do not lift heavy equipment immediately after the surgery, as it may stain the incision site.

You should call your doctor if you find any of the following symptoms.

• Vision changes
• Seizure activity
• Trouble in breathing
• Chest pain
• Weakness in your arm or legs.
• Green, yellow, or blood-tinged sputum
• Change in mental status
• Increased pain during the incision site
• Seizure Activity

Benefits Of Medical Tourism

There are some countries that undoubtedly offer high-quality medical care. However, the treatment and surgery costs are quite high, which many patients cannot afford. Again, patients have to wait longer to access medical care, which is quite critical for brain injury patients. 

Do you have a brain tumor or clots in your brain? Has your Neurosurgeon recommended craniotomy surgery, and do you want the operation done at an affordable cost? If yes, then you can choose a medical tourism destination like India. 

You will get their extreme medical care at an affordable range. Neurosurgeons in medical tourism destinations are highly skilled and have many years of experience handling craniotomy surgery.

Racure Healthcare is one of the best medical tourism Companies in India. It provides treatment, travel, and logistics services. The Company arranges a video consultation with the doctor before arriving at the destination. 

Simultaneously, it books flights so that a patient can travel without stress to the destination. You can check Racure Healthcare's website to learn more about its services.

Conclusion

A craniotomy is a complex surgery used to treat various conditions, such as brain tumors, epilepsy, or draining pus from the brain. After the surgery, you can lead an everyday life. If you struggle to pay the surgical bills, consider a medical tourism destination like India.

Contact Racure Healthcare today. The Company will appoint a personal care executive who will stay with you from your arrival to the treatment.