Craniotomy, often referred to as the “window to the brain,” is a complex surgical procedure that plays a vital role in treating a wide range of neurological conditions. From brain tumors to traumatic brain injuries, craniotomy offers hope and healing to countless individuals facing daunting medical challenges. In this blog post, we’ll explore the ins and outs of craniotomy, from its indications and procedure to recovery and beyond.

What is Craniotomy?

Craniotomy is an operation in which a small hole is made in the skull or a piece of bone from the skull is removed to show part of the brain. A craniotomy may be done to remove a brain tumor or a sample of brain tissue. It may also be done to remove blood or blood clots from the brain, relieve pressure in the brain after an injury or stroke, repair a skull fracture or brain aneurysm (a bulge in a blood vessel wall), or treat other brain conditions. The piece of bone that is removed from the skull is usually put back in place after the surgery has been done.

What is craniotomy surgery used for?

Craniotomy surgery may be used to treat:

  • A tumor.
  • A blood clot.
  • An abnormal collection of blood vessels (vascular malformations).
  • Tangled blood vessels (arteriovenous malformation).
  • Artery enlargement (aneurysm).
  • Swelling or pressure in your brain.
  • Epilepsy
  • A skull fracture.

What happens during a craniotomy?

The first step is for an anesthesiologist to administer anesthesia and monitor your vitals throughout the procedure. Then, the nurse will shave the part of the head the surgeon will operate on. The surgeon will make an incision in the head to get access to the skull. Afterward, the surgeon will use a medical drill to burrow a hole in the skull and remove part of the bone to get access inside. The flap will be saved to be put back later on or replaced with an artificial bone. The dura matter will be separated from the skull bone to access the brain inside. At this point, the surgeon can make the necessary repairs and removals depending on your condition and needs. Once complete, the surgeon will sew the tissues together and reattach the bone flap or replace it with an artificial piece. Finally, the incision will be closed with sutures or staples and then bandaged.

What happens after surgery?

You are taken to the recovery room where vital signs are monitored as you awake from anesthesia. You may have a sore throat from the tube used to assist your breathing. After you awaken, you’ll be moved to the intensive care unit (ICU) for close monitoring. You are frequently asked to move your arms, fingers, toes, and legs. A nurse will check your pupils with a flashlight and ask questions, such as “What is your name?” You may experience nausea and headache after surgery. Medication can control these symptoms. Depending on the type of brain surgery, steroid medication (to control brain swelling) and anticonvulsant medication (to prevent seizures) may be given. When your condition stabilizes, you’ll be transferred to a regular room where you’ll begin to increase your activity level.

The length of the hospital stay varies, from only 2–3 days or 2 weeks depending on the surgery and any complications. When released from the hospital, you’ll be given discharge instructions.

Is craniotomy a serious surgery?

Yes, a craniotomy is a major surgery. It involves temporarily removing part of the skull to expose the brain for surgery. 

Some risks of a craniotomy include:

  • Cerebral bleeding or hematoma at the surgical site
  • Seizures
  • Stroke
  • Cerebrospinal fluid leak
  • Brain swelling
  • Infection at the surgical site
  • Bleeding
  • Inflammation
  • Accumulations of fluid in the brain 

How successful is craniotomy?

The success rate of a craniotomy depends on various factors including the reason for the surgery, the patient’s overall health and post-operative care. In many cases, craniotomies are successful in treating conditions such as brain tumors, aneurysms, and traumatic brain injuries, but outcomes can vary widely from patient to patient.

How long is recovery from craniotomy?

Because a craniotomy is part of the surgery to treat many conditions, your recovery is going to be a very personal process. Much will depend on the condition being treated, as well as your individual health factors. The average recovery time for a craniotomy is about six to eight weeks. Full recovery can take a few months and depends on the underlying condition that was treated. 

Does hair grow back after craniotomy?

Yes, hair will grow back after a craniotomy, where it has been shaved. However, a certain amount of hair loss is inevitable along the scalp incision.

Can you live normal life after craniotomy?

Many people make a full recovery after the surgery with minimal side effects. While your incision site can heal within weeks, you’ll likely need months of rehabilitation centre services and lifelong follow-up care after a craniotomy.

What is the difference between a craniotomy and a craniectomy?

While both a craniotomy and a craniectomy are types of brain surgery, they’re different procedures. A craniotomy removes and replaces a piece of your skull to access your brain. A surgeon will also remove a piece of your skull during a craniectomy, but the removed piece of skull isn’t immediately put back into place after surgery. You may need a follow-up surgery called a cranioplasty to replace the missing part of your skull.