The term “craniotomy” refers to the removal surgically of a portion of bone from the skull, exposing the brain. Specialized instruments are used to take out the piece of bone, referred to as”the bone flap.
The flap of bone is removed for a short time, and it is replaced once the brain surgery is completed.
Certain procedures for craniotomy may rely on the assistance of computers or images (magnetic resonance imaging, also known as MIRRor computerized tomography scans) to locate the exact area of the brain that will be treated.
This procedure involves the utilization of a frame on the skull or a frameless method with markers that are placed in a superficial manner or markers on the scalp.
If one of these imaging techniques is utilized in conjunction with the craniotomy procedure it’s referred to as stereotactic cranial surgery.
Who Is Responsible for the Process?
A craniotomy can be performed by a neurosurgeon. A few are also trained for skull-base surgery. A neurosurgeon could be part of the head-and-neck team, Otologic, Oculoplastic, and reconstructive surgeons.
Talk to your neurosurgeon about their education, particularly in cases that are more complicated.
What Happens in the Days Before Surgery?
The surgeon will discuss the procedure as well as the risks and benefits and give you the chance for questions. Consent forms are completed and paperwork is filled out to notify the surgeon of your medical background (e.g. reactions to medications, allergies, reactions, prior procedures).
Tests for pre-surgical procedures (e.g. blood tests electrocardiogram, chest X-Ray) could require a few days prior to surgery. Ask your primary physician regarding taking off certain medications and make sure you’re approved to undergo surgery.
Stop taking any non-steroidal anti-inflammatory drugs (ibuprofen naproxen.) or blood thinners (Coumadin Aspirin, Plavix, etc.) seven days prior to surgery.
Avoid drinking nicotine and alcohol for a week prior to surgery and two weeks following surgery to prevent bleeding and other issues with healing.
If you are planning to undergo an image-guided procedure for your surgery, an MRI will be scheduled prior to surgery.
These fiducials (small markers) can appear on your forehead or behind your ears. They help align the preoperative MRI with your image guide system. The fiducials need to remain in place and can’t be removed or moved prior to surgery, to ensure an accurate scan.
You might be asked to cleanse your hair and your skin using the Hibiclens (CHG) and Dial soap prior to your surgery. It kills bacteria and helps reduce infections at the surgical site. (Avoid the risk of contracting CHG in the eyes nose, ears, and genital area. )
Day of Operation
- No food, drinks, or gum.
- Shower with antibacterial soap. Dress in clean loose-fitting clothes.
- Wear flat-heeled footwear with close-backs.
- If you’re required to take regular medications the day before surgery, you should do it by taking tiny sips of water.
- Remove make-up, hairpins, hair extensions/weaves, contacts, body piercings, nail polish, etc.
- Keep all jewelry and valuables in the home.
- Include an inventory of your medications, including doses and the time of day at which they are usually used to take them.
- Include an allergy list for food or medication.
The patients are taken to the hospital in the morning before surgery. The nurse will go over the process prior to surgery and address any concerns you might have. An anesthesiologist will meet with you to explain the benefits of anesthesia as well as the risk.
How Can You Take Care of Yourself at Your Home?
Activity
- Relax when you are exhausted. It’s normal to rest throughout the daytime. It’s best to plan an afternoon nap each day. Sleeping enough can help you recuperate.
- Make sure you don’t lie on your back in bed or when you sleep. You can make use of an inflatable pillow or put an unrolled towel or foam padding beneath your pillows. You can also elevate the top of your bed by putting wooden or brick blocks underneath the bed’s legs.
- When you’ve gotten up, raise your head slowly up. This will help prevent headaches and dizziness.
- Hair can be washed for 2 to 3 days following the procedure. Do not wash your hair or bathe for 2 to 3 months.
- Do not dye or color your hair for 4 weeks following the procedure.
- Do your best to walk each day. Begin by walking a bit more than the previous day. Gradually, increase the amount you walk. Walking improves blood flow and also helps to prevent constipation and pneumonia.
- Do not lift heavy until you are told by your physician that it’s fine.
- Avoid driving for up to three weeks, or until you get a medical opinion that it’s okay.
- Consult your physician to determine if it’s safe to travel via plane.
Diet
- You can still eat your regular diet. If you are experiencing stomach upset Try bland, low-fat food items such as broiled chicken, plain rice toast, toast, and yogurt.
- Follow your doctor’s instructions regarding the amount of liquid you need to drink following surgery.
- Don’t consume alcohol until your physician has confirmed that you are okay.
- It is possible that you notice the bowel movements do not seem to be normal following the operation. This is normal. Avoid constipation or straining when you go through your bowel movements.
- You might want to consider taking a fiber supplement daily. If you’ve not experienced an intestinal movement for several days, consult your physician to prescribe an easy laxative.
Medicines
- Your doctor will inform you when and if you are able to start taking your medication again. Also, your doctor may provide directions on taking any new medications.
- If you’re taking aspirin or any other blood thinner consult your physician about whether you should take it again. Be sure you know precisely what the doctor is asking you to follow.
- Take care when taking medication. Make sure you take pain medication exactly as prescribed.
- If your doctor has given you a prescription for a medicine to treat pain, you should take it according to the directions.
- If you’re not taking prescription pain medication, inquire with your physician if you are able to buy over-the-counter medicine.
- If you believe your pain medication makes you feel sick to your stomach:
- Do your medicine at the end of eating (unless your physician has instructed that you should not).
- Consult your physician to prescribe a different pain medication.
- If your doctor has prescribed antibiotics, you should take them as prescribed. Don’t take them off because you are feeling better. It is essential to follow the entire course of antibiotics.
- If you take medicines to treat seizures, use them exactly as directed.
Life After Craniotomy
Once you’ve recovered fully, however, it’s essential to care for your health. This can help prevent future problems and improve your outlook over time.
Keep seeing your doctor regularly for appointment follow-ups.
It is also advisable to:
- Exercise regularly
- Eat a healthy diet
- Limit alcohol consumption or stay clear of it
- Stop smoking (this is a difficult one) (this can be difficult to do, but a physician can aid in creating a plan that will work best for you)
- Sleep enough
Takeaway
A craniotomy is when the surgeon removes part of your skull and performs surgery on the areas that comprise your brain. It could be done to eliminate a tumor, as well as treat an aneurysm in addition to other reasons.
As with all surgeries, the craniotomy procedure can result in complications. Your surgeon will devise the most effective treatment plan to lower the chance of complications.
Follow the instructions of your doctor for home care. Call them right away if you have severe seizures, headaches, or symptoms of wound infection.