Overview & Description

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

Who is a candidate for the procedure?

A craniotomy allows the surgeon to do the following:

  • remove a lesion, such as a brain tumor
  • remove a blood clot, such as a chronic subdural hematoma
  • repair a leaking blood vessel, known as an cerebral aneurysm
  • remove an abnormal collection of blood vessels, known as arteriovenous malformation, or AVM
  • drain a pocket of pus, also called a brain abscess
  • repair skull fractures caused by a head injury
  • repair a tear in the membrane lining the brain
  • relieve pressure within the brain, which is also called increased intracranial pressure
  • How is the procedure performed?

    A craniotomy is performed under general anesthesia. This means theperson is put to sleep with medication and cannot feel any pain. The hair onpart or all of the scalp is shaved. An incision is made in the scalp over thearea of the suspected condition or disorder. A flap of the bone is cut awayfrom the skull and set aside during the surgery. The disorder is located andtreated. The bone flap is replaced, and the scalp is closed with sutures orclips.

    Preparation & Expectations

    What happens right after the procedure?

    After the procedure, the person will be taken to the surgeryrecovery room or an intensive care unit. A breathing tube, or endotrachealtube, may be left in place for a short timeuntil the effects of the anesthesia have worn off.

    Since there is some risk involved with this surgery, a healthcare provider willcheck vital signs often by doing the following:

  • Check the reaction of the person’s pupils 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 he or sheis.
  • Evaluate movement in the person’s arms and legs.
  • A turban-like dressing or soft adhesive dressing will be placed over theincision. Pain medication will be given as needed.

    Home Care and Complications

    What happens later at home?

    Most people need to stay in the hospital from 5 to 14 days after acraniotomy. Their activity is slowly increased. It is common for people to feel tired for6 weeks after surgery. Depending on the area of the brain affected, the personmay need physical therapy, occupational therapy, orspeechtherapy to regain normal function.

    If surgery was performed for a cancerous brain tumor, radiationtherapy or chemotherapy may be needed.

    What are the potential complications after the procedure?

    Complications from a craniotomy may include the following:

  • bleeding into the brain, which may require a second craniotomy
  • infection
  • allergic reactions to anesthesia
  • stroke
  • seizures
  • swelling of the brain, which may require a second craniotomy
  • permanent brain damage with associated disabilities
  • Article type: xmedgeneral