Imagine that someone from your family is rushed to the hospital due to an accident or a stroke. The doctors there say, "The pressure on the brain is too high, and to save their life, they need to do a surgery right away, which is called a craniectomy." It is normal for us to feel very scared and shocked when we hear this word. But behind this terrible name lies the hope of saving a life. So, today we will talk about this surgery called craniectomy very simply, in a way that you can understand.
What is a craniectomy in simple terms?
Simply put, a craniectomy is a major brain surgery that involves temporarily removing part of your skull to relieve pressure inside your brain.
It's like this, imagine your brain is a balloon. The skull is a closed box that holds the balloon. If for some reason the brain starts to swell, that is, if the balloon starts to inflate, there is not enough room inside the box. Then the balloon can burst and burst. Craniectomy surgery removes one side of that box and allows the balloon to inflate freely. This can greatly reduce the damage to the brain.
The most important thing is that the skull fragment removed during this surgery is not immediately reattached. After the swelling in the brain has completely gone down and the pressure has returned to normal, another surgery is performed on a separate day to reattach the skull fragment. We call this second surgery a cranioplasty .
In what cases is this surgery necessary?
Doctors may decide to perform this surgery in any situation where the pressure inside the brain (intracranial pressure) is increased and life-threatening. The main causes of these conditions are:
| Cause | Simple Explanation |
|---|---|
| Serious Traumatic Injury | A serious head injury from an accident, fall, or assault can cause the brain to swell. |
| Stroke | A blockage or rupture of a blood vessel supplying blood to the brain can cause brain cells to die and swell. |
| Blood Clot in the Brain | A blood clot can become lodged inside a blood vessel in the brain, causing increased pressure. |
| Hematoma | The brain begins to swell due to blood accumulating inside the skull, around the brain, or inside the brain. |
What happens during the surgery?
This is often an emergency surgery, so there is not much time to prepare. The doctor and the medical team quickly perform the necessary tests (blood tests, CT scan, MRI scan) and refer you for surgery. Here is a step-by-step guide to what happens during the surgery:
1. Anesthesia: First, you will be fully anesthetized. This means that you will be asleep and will not feel any pain during the surgery.
2. Preparation: The hair on the part of the head where the surgery will be performed is removed, and the area is thoroughly cleaned and disinfected.
3. Incision: The doctor will cut the skin to expose the skull. Then, the muscles and tissues will be removed and the skull will be raised.
4. Skull removal: Using a special medical instrument (drill), several holes are made in the skull, a cut is made through those holes, and the required part of the skull is carefully removed.
5. Treatment: After removing the skull, the cause of the pressure on the brain (for example, a blood clot) is removed or the necessary treatment is performed.
6. Finishing the surgery: The open part of the brain is covered with a special mesh. Then the previously removed skin and tissue are returned to their original position and the skin is closed with stitches or staples.
The entire process usually takes about three to five hours, but this can vary depending on the patient's condition.
What happens after the surgery?
After surgery, you will be transferred directly to the intensive care unit (ICU) , where the medical team will monitor your condition 24 hours a day, including your heart rate, blood pressure, and brain swelling.
Most importantly, since part of your skull has been removed, you will be given a special protective helmet to wear to prevent any damage to your brain. You will need to wear this helmet after you leave the hospital, until the second surgery is performed and your skull is reattached.
While you are in the hospital, the medical team will advise you and your family on how to rest with your head up and how to take care of yourself.
What are the benefits and risks of this surgery?
Like any major surgery, craniectomy has its benefits and risks.
| Benefits | Risks & Complications |
|---|---|
|
|
| It should be noted: Despite these risks, this surgery is performed as a last resort, to save life when there are no other options. The medical team does everything possible to minimize these risks. | |
How long does it take to heal?
This is the biggest problem for many people. The recovery time after a craniectomy varies greatly from person to person. It depends on the reason for the surgery, the extent of the damage to the brain, and your overall health.
- Skin wound: May heal in a few weeks.
- Full recovery: However, it can take months, even years, to fully recover.
- Rehabilitation: Many people may have difficulty speaking, walking, and performing daily activities. Therefore, rehabilitation treatments such as physiotherapy, occupational therapy, and speech therapy are required for a long period of time.
This is a long journey that requires a lot of patience and the support of family. Don't expect quick results.
When to see a doctor
After leaving the hospital, you should be very careful if any warning signs appear.
| Features to look out for | |
|---|---|
| If you have these symptoms, inform your doctor immediately. | |
| |
| If these things happen, call 1990 immediately or go to the hospital's Emergency Treatment Unit (ETU). | |
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Take-Home Message
- Craniectomy is a life-saving surgery performed to relieve life-threatening pressure inside the brain.
- Here, a portion of the skull is temporarily removed and then reattached a few months later through a cranioplasty surgery.
- It is mandatory to wear a special helmet to protect the brain after surgery.
- The recovery process is very long, requiring rehabilitation treatment, patience, and the unwavering support of family.
- Inform your doctor immediately about any unusual symptoms that may occur after surgery.
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