It is very normal for anyone to feel a little scared and anxious when they are told that they need to have brain surgery. It is not just you, it is a common feeling for everyone. However, when you are properly and clearly informed about this surgery, your fear and doubt can be reduced to a great extent. So today, let's talk about everything about this brain surgery, which is called `(Craniotomy)` in medicine.
Simply put, what is this Craniotomy?
A craniotomy is a surgical procedure in which a neurosurgeon temporarily removes a small piece of bone from your skull to access your brain, performs the necessary surgery, and then reattaches the removed piece of bone . This is major surgery. Doctors usually perform this type of surgery for serious conditions like a brain tumor, a life-threatening illness, or a head injury from a serious accident.
Now you might be wondering, there's another surgery like this called a craniectomy, what's the difference between the two?
In a craniotomy , the bone fragment removed from the skull is reattached during the same surgery . However, in a craniectomy , the bone fragment is not reattached immediately. This is because if there is swelling in the brain, it needs to be allowed to subside. Later, the bone fragment is reattached in a separate surgery (`(Cranioplasty)`).
Why do you need to have this kind of surgery?
There are many reasons why a craniotomy may be performed. If your doctor has suggested this type of surgery for you, it may be for one of the following reasons.
| Reason for surgery | A simple explanation |
|---|---|
| Brain tumor | To remove abnormal cell growth in the brain. |
| Blood clot | Remove a blood clot inside the brain and restore blood flow. |
| Blood vessel problems | For example, repair an aneurysm or arteriovenous malformation. |
| Swelling or pressure on the brain | If the pressure inside the brain has increased, reduce it. |
| Epilepsy | In some severe cases of epilepsy, to remove the part of the brain that is causing the disease. |
| Skull fracture | To reattach the skull when it is fractured in a severe accident. |
How do you prepare before surgery?
Your medical team plans everything carefully before a major surgery like this, and you need to support that too.
Before the surgery, you will need to do the following:
- Doctor's appointment: Your surgeon will talk to you in detail about the surgery, its risks, and the results. Ask any questions or concerns you may have at this time .
- Several tests: In addition to blood tests to check your health, imaging tests such as `(MRI)`, `(CT scan)`, `(PET scan)` may also be ordered to check the condition of your brain.
- Pre-surgery instructions:
- They tell you to eat an empty stomach the day of the surgery.
- If you are taking blood thinners, you will be asked to stop taking them a few days before the surgery.
- You may also be asked to start antibiotics or other medications early to prevent infection.
The most important thing is to follow your doctor's instructions exactly. This is very important for the success of the surgery.
What happens during the surgery?
On the day of your surgery, you will be given anesthesia (`(Anesthesia)`). This means you will be completely asleep so that you will not feel any pain. In the operating room, your head and body will be positioned exactly as needed, and the surgery will begin.
1. Preparation: First, the hair around the surgical site is trimmed and the area is thoroughly cleaned to remove any germs.
2. Skin incision: Next, the doctor makes a skin incision.
3. Removing the bone: Next, a small piece of the skull bone is cut using special instruments and carefully removed. This piece of bone will need to be reattached later, so it is safely set aside.
4. Brain surgery: The brain can now be accessed. The doctor will address the problem that caused the surgery (e.g., removing a tumor, repairing a blood vessel).
5. Reattachment: After the brain surgery is complete, the removed skull bone is put back together like a puzzle, secured with small plates and screws. After that, the skin is sewn back together.
The entire surgery usually takes about 3-5 hours, but it can be longer depending on what is being done.
Do you sometimes do this surgery while you're awake?
Yes, that's right. In some special cases, this surgery has to be done while you're awake. It's called an "Awake Craniotomy." Imagine, if the area to be operated on is near a part of your brain that controls speech, vision, or movement, the surgeon wants to see if those functions are happening during the surgery. But don't worry, you won't feel any pain . Because the brain doesn't feel pain, and your skull and skin are numbed. The doctor will ask you to speak, identify a picture, or move your hand, so he can operate on the right spot.
What happens after the surgery?
After surgery, you will be admitted to the intensive care unit (ICU). There, your condition (breathing, heart rate, blood pressure) will be constantly monitored by the medical team. Once your condition is stable, you will be transferred to a regular ward.
- Hospital stay: Usually, you will have to stay in the hospital for about a week.
- Rest: It is important to rest in bed with your head slightly elevated during this time.
- Recovering at home: After you go home, rest is the most important thing . It usually takes about 6-8 weeks to fully recover. You should definitely check with your doctor before going to work or doing any strenuous activity.
Are there any side effects or risks?
As with any major surgery, there are risks and complications that can occur with a craniotomy. However, with modern medical techniques, these are very rare. The surgical team does their best to prevent these.
Possible risks may include:
- Bleeding (`(Bleeding)`)
- Pain
- Infection (`(Infection)`)
- Status epilepticus (`(Seizures)`)
- Stroke
- Headache
Although long-term side effects such as difficulty walking, difficulty speaking, or behavioral changes may occur, these are very rare. Your doctor will explain these risks to you in advance.
When do you need to see a doctor?
Once you get home, take good care of your health. It's important to report any problems as soon as possible.
| Situations requiring urgent attention | |
|---|---|
| Talk to your doctor: |
|
| Go to the hospital's Emergency Department (ETU) immediately: |
|
Ultimately, a craniotomy is a very important surgery that can treat serious conditions and save lives. Most people make a full recovery and lead normal lives after the surgery. The most important thing is to trust your medical team, follow their instructions, and let them know if you have any concerns.
Take-Home Message
- Craniotomy is a major surgery in which a portion of the skull bone is temporarily removed and then reattached to access the brain.
- This is done to treat serious conditions such as brain tumors, blood clots, and accidents.
- It is very important to follow the doctor's instructions carefully before surgery and to ask any questions you may have.
- Rest is essential for complete recovery after surgery, which usually takes about 6-8 weeks.
- If you experience any unusual symptoms (severe pain, fever, fit) during your recovery, seek medical advice immediately.
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