In certain cases, a craniotomy must be done to treat a hematoma (bleeding inside the brain). A craniotomy is a surgery that temporarily removes a section of the skull to operate on the brain. Bleeding inside the brain – or hematoma – is typically caused by a traumatic head injury because of a fall, car accident, or sports injury. These cases are more common in the elderly or those who take anticoagulant medication/blood thinners. Since these traumatic injuries can cause unconsciousness and even death, craniotomies are often life-saving surgeries.
The Craniotomy Procedure
A craniotomy may be performed under general or local anesthesia. A patient is generally under local anesthesia when it is necessary to check for brain function during the surgery. The incision site on the scalp is first shaved off. This allows easy access to the surgeon and also prevents potential infections. An incision is made in the scalp and the bone flap is carefully removed. The incision site depends on the area needing operating. Different tools may be used depending on the location, such as a medical drill to create small holes or a special saw. After the bone flap is removed, the scalp is clipped to prevent bleeding. The dura mater, or the membrane that covers the brain, is carefully separated from the skull and cut to release any accumulated, excess fluid. The surgeon may need to use microsurgical instruments to precisely view the area. To finish the procedure, the surgeon will stitch together any cut tissue. The bone flap will then be reattached firmly through plates, sutures or wires.
Recovery From A Craniotomy Procedure
The postsurgical craniotomy patient spends some time in intensive care (ICU) until vital signs are stable and the patient is alert. Once out of ICU, the patient will remain in the hospital for several days. Oxygen will be given to help with breathing; respiratory therapy is necessary to ensure the patient’s lungs re-expand and that the patient doesn’t develop pneumonia.
During recovery in the hospital, the patient will also wear sequential compression devices (SCDs) to prevent the formation of blood clots in the legs. To confirm brain functions, he/she will be given neurological and cognitive tests regularly. The patient’s head is kept elevated to keep swelling to a minimum. Many patients who have undergone a craniotomy spend several days in a rehabilitation facility after the procedure.