What is a craniotomy?
Craniotomy is a procedure in which a neurosurgeon surgically removes a section of the skull in order to gain access to the brain. The portion of skull removed is called a “bone flap,” which is often placed back in its original position after the operation is completed. The bone flap is typically fastened into place with low-profile titanium plates and screws. When the surgeon does not replace the bone flap for some reason, it is called a “craniectomy.”
A craniotomy guided by MRI-based navigational software is called a “stereotactic craniotomy.” Stereotactic craniotomy is usually the standard procedure in planned surgeries. With improvement in navigational software accuracy and surgical techniques, surgeons choose to do minimally invasive keyhole craniotomies when possible.
A less invasive method is a “burr hole” craniotomy in which the surgeon drills a hole in the skull. This provides a limited view and may be used for draining cerebrospinal fluid, draining blood from a hemorrhage, and to relieve pressure on the brain (intracranial pressure). The burr hole may also be used as a port for an endoscope, so the surgeon is able to determine a further course of action during the procedure.
When is a craniotomy performed?
A neurosurgeon performs a craniotomy to access the brain for surgery. The surgery maybe involve the following:
- brain tissue,
- blood vessels in the brain,
- meninges (the membranes covering the brain)
- skull bone
A craniotomy maybe required for the following surgeries:
- Clipping of a cerebral aneurysm
- Resection of arteriovenous malformation (AVM)
- Removal of brain abscess
- Resection of brain tumor
Biopsy or resection of abnormal brain tissue
How serious is crainotomy surgery?
Craniotomy, like any surgical operation, carries its particular risks. Craniotomy is primarily a means to an end, so the seriousness of complications may depend mostly on the location on the brain and the type of surgery performed. Despite potential complications, a craniotomy may save lives, and individuals with no other pre-existing conditions are likely to recover fully with good care and treatment.
The following are some of the risks with craniotomy that are common to any surgery:
- blood clots
- reaction to anesthesia
- unstable blood pressure
- myocardial infarction
Some of the specific complications that can arise post-craniotomy are:
- cerebral bleeding or hematoma at the surgical site
- seizures due to disruption of normal brain tissue
- stroke due to damage to a blood vessel
- cerebrospinal fluid leak
- brain swelling
- infection at the surgical site
- air within the cranium (pneumocephalus) introduced through the craniotomy site, which may cause confusion, lethargy, headache, seizures, and nausea/vomiting
Some individuals, depending on the location, site of surgery, and pre-existing medical conditions prior to surgery might encounter:
In patients with certain medical conditions the risks are higher, and the surgeon might decide on surgery only if the benefits of surgery outweigh the risks. The following factors increase the risks involved in a craniotomy and brain surgery in some patients:
- advanced age
- cardiopulmonary disease
- poor functional health
- systemic collapse due to sepsis or multi-organ failure
Many of the risks associated with a craniotomy have been minimized with pre-procedure blood tests, advanced imaging technologies, improved surgical techniques, postoperative care and medications.
Top Is Craniotomy a Serious Surgery Related Articles
Brain AneurysmA brain aneurysm (cerebral aneurysm) is caused by microscopic damage to artery walls, infections of the artery walls, tumors, trauma, and drug abuse. Symptoms include headache, numbness of the face, dilated pupils, changes in vision, the "worst headache of your life," or a painful stiff neck. Immediate treatment for a brain aneurysm is crucial for patient survival.
Brain CancerCancers that form from brain tissue are called primary brain tumors. Brain tumors may be malignant (brain cancer) or benign. Certain risk factors, such as working in an oil refinery, as a chemist, or embalmer, increase the likelihood of developing brain cancer. Symptoms include headaches, weakness, seizures, difficulty walking, blurry vision, nausea,vomiting, and changes in speech, memory, or personality. Treatment may involve surgery, radiation therapy, or chemotherapy.
Brain Cancer: Tumor Signs, Symptoms, and TreatmentBrain cancer, types of which include primary or secondary cancer, involves invasive brain tumors including gliomas and glioblastomas. Learn the brain cancer survival rate, treatment options including chemotherapy, and the different brain tumor grades. Find out how the right treatment plan can fight cancerous brain tissue.
ConcussionA concussion is a short-lived loss of brain function that is due to head trauma. There are two types of concussion, simple and complex. Symptoms of a concussion include headache, nausea, dizziness, dazed feeling, irritability, and visual symptoms. Physical signs include poor concentration, emotional changes, slurred speech, and personality changes. Concussion is diagnosed with physical examination and testing. Treatment for a concussion in general includes treatment for control of the symptoms and time.
Brain HemorrhageA brain hemorrhage is a type of stroke caused when an artery bursts in the brain, causing localized bleeding in the surrounding tissue. Causes of brain hemorrhage include aneurysm, liver disease, brain tumor, head trauma, high blood pressure, and blood vessel abnormalities. Symptoms and signs include sudden severe headache, nausea, vomiting, loss of balance, tingling, numbness, vision changes, loss of consciousness, and loss of fine motor skills. Treatment depends upon the cause, location, and size of the brain hemorrhage.
Brain Lesions (Lesions on the Brain)A brain lesion is defined as an area of damaged brain. Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, and weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally accomplished with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
Differences Between Left-Handed vs. Right-Handed PeopleRight- and left-handed people can differ in very noticeable ways. Find out how and why.
Brain PictureThe brain is one of the largest and most complex organs in the human body. See a picture of the Brain and learn more about the health topic.
10 Facts About the Amazing Brain QuizTake this brain quiz to learn about your amazing brain! It's the most complex part of your body, and is responsible for many functions, including how you behave!
Concussions & Brain Damage QuizWhat is a concussion? Learn causes, symptoms, and treatments of this very common traumatic brain injury by taking this quick quiz.
Brain Injuries SlidesConcussions are a common type of traumatic brain injury. Read more about symptoms of a concussion, how to treat head injuries, and learn about tests used to diagnose concussions.
Deep Brain StimulationDeep brain stimulation (or DBS) is a way to inactivate parts of the brain that cause Parkinson's disease and its associated symptoms without purposefully destroying the brain. In deep brain stimulation, electrodes are placed in the thalamus (to treat essential tremor and multiple sclerosis) or in the globus pallidus (for Parkinson's disease).
Head Injury (Brain Injury)In the United States, head injuries are one of the most common causes of death and disability. Head injuries due to bleeding are generally classified by the location of the blood within the skull, these include epidural hematoma, subdural hematoma, subarachnoid bleed, intracranial bleed, sheer injury, edema, and skull fracture. Some common symptoms of a head injury include vomiting, bleeding from the ear, speech difficulties, paralysis, difficulty swallowing, and body numbness. Treatment of a head injury depends on the type and severity of the injury.
How Conditions Change Your BrainThe brain doesn’t always stay the same. Mental disorders, health issues, and lifestyle habits can alter the way it looks and works.
How Dangerous Is General Anesthesia?General anesthesia drugs induce unconsciousness to prevent the patient from feeling any sensations at all while surgeons perform procedures that would otherwise cause unbearable pain. It is generally safe, but comes with risks like breathing problems and inhaling fluid in the lungs, blood pressure and heart function issues and allergic reactions to the medications.
How the Brain Works: Test Your Medical IQTake this quiz and test your knowledge of how the human brain works. You may be surprised!
What Is Intraoperative Neurophysiological Monitoring?Intraoperative neurophysiological monitoring is the continuous evaluation of a patient’s nervous system during surgery, especially procedures involving the brain and spinal cord. Electrical and electromagnetic sensors connected to the patient via adhesive electrodes or needles transmit information from the nervous system that can be monitored on a computer screen.