For most people, the phrase "craniotomy" causes discomfort. Many have heard that similar operations were carried out in antiquity, but if necessary, they are successfully carried out today. What is craniotomy done for ? What it is? In what cases is surgery necessary, how scary is it, and can a person live a full life after such a procedure?
An operation performed to dissect the soft tissues of the head and cranial bones in order to penetrate and further investigate or operate on brain tissue is called “craniotomy”. What does this mean and to whom is this treatment prescribed?
Indications for trepanation
Trepanation can be prescribed to patients who have various brain diseases, oncological formations, edema, blood clots, problems with the blood vessels of the brain, nervous disorders, tissue infections and vascular disorders of the hard shell of the brain. An operation is also prescribed for head injuries, for fractures or indentation of the bones of the skull, as well as for relieving intracranial pressure. Another indicator for the procedure may be a biopsy. The operation trepanation of the skull allows you to take a piece of brain tissue for further research.
Operation types
The procedure is carried out in different ways, which one will be prescribed for this or that patient - is determined by general indications and the nature of the disease.
- Osteoplastic craniotomy (traditional) . In the process, a separate section of the cranial bone is cut out. Then, an operation is performed on the brain, after which the removed part of the bone returns to its place. If the procedure is successful, additional intervention is no longer required.
- Resection craniotomy . What does it mean? A small hole is made in the cranium and expands to the desired diameter. Unlike the first type, the opening of the skull after surgery is not blocked by bone tissue. The brain is no longer protected by the bones of the skull; only skin and soft tissues perform this function.
- Decompressive trepanation consists in making a small hole in the bones of the skull. This procedure is prescribed to patients in order to reduce intracranial pressure.
- A craniotomy in consciousness is when a craniotomy operation is performed on a conscious patient. Such a procedure is necessary to track the functionality and response of the brain to various surgeon manipulations. The patient does not experience pain.
- Stereotaxia This study uses a computer. With its help, an examination of brain tissue is carried out, which after undergoes surgery.
How to prepare for surgery
What does a patient need to know for craniotomy? What is this procedure, how it will be carried out and how to organize your life for a speedy recovery after it - all these issues should be discussed with your doctor in advance. Before the operation, you must go through all the necessary studies of the brain and nervous system, take tests.
A week before surgery, you should stop taking blood thinners and anti-inflammatory drugs. Medication should be strictly controlled by a doctor, self-medication in this period is unacceptable. Before the operation itself (in 12 hours), you need to give up food and liquid.
Care should be taken about who and how will be able to pick up the patient from the clinic after discharge, who will be able to help around the house during the recovery period and provide other care assistance.
Anesthesia
"How do craniotomy and does it hurt?" - Perhaps one of the most common questions in patients. The operation in most cases is performed under general anesthesia. Neither the trepanation, nor the surgeon's manipulations with brain tissue will be felt by the patient. After trepanation, painkillers will be prescribed.
In the case of stereotaxia, analgesia is prescribed locally. If a craniotomy is prescribed, in which the patient must remain conscious, general anesthesia will be provided for the period of the operation when a person is not required to remain conscious.
Operation process
After the patient is anesthetized, the skin on the head is thoroughly treated with an antiseptic. An incision is made, exposing the necessary area of the skull. The trepanated bone of the skull is excised, removed, and brain surgery is performed.
At the end of the intervention, the exposed area of the brain closes. The removed part of the cranial bone returns to its original place, and surgical sutures are applied to the scalp. To ensure fluid outflow and blood removal, drainage tubes are inserted into the operated area, and a bandage is applied to the head. After a few days, the drainage can be removed. The operation itself lasts several hours.
After the patient is sent to the postoperative ward, where his vital signs are carefully monitored. Heart rate, body temperature, respiration, and blood pressure are checked regularly. After a while, the operated person will be transferred to the intensive care unit, and then to the hospital ward.
Postoperative period
After the operation, in which craniotomy was used, the restoration of the patient's health begins immediately. The operation itself is quite complex and takes a lot of effort from the patient, so the rehabilitation process is very important. The patient will be in the clinic for 3 to 7 days, the period depends on the severity of the operation and the patient’s health. If complications arise, then the length of stay under the supervision of a doctor will be increased.
Hospital care
It will boil down to the following:
- The patient's head should be kept upright to lower blood pressure.
- Fluid intake will be limited, in case of vomiting, antiemetics are prescribed.
- Medications that reduce the amount of fluid in the body (steroids) may be prescribed.
- Antibiotics are used to prevent infection.
- After a day, the bandage can be removed from the head of the operated. The wound should be kept clean and constantly monitored.
- The patient should begin to walk a little as early as possible. This will prevent the occurrence of pneumonia or the formation of blood clots.
Upon returning home
Excessive loads after such a complex operation are contraindicated, as well as playing sports. It will be very good if someone from the family helps a person organize his life during the first time he is at home. People after craniotomy often experience psychological stress and depression. They need to communicate with a positive person. Who else, if not close, will be able to help with this. In some cases, it’s not possible to cope with depression yourself, then you should seek professional help from a psychologist or psychotherapist.
It is equally important to follow the instructions and follow the doctor’s recommendations, which will observe the patient who underwent craniotomy. The consequences of the operation and the speed of recovery largely depend on postoperative care. The operated area of the head should be kept clean. You can not wet the wound for a long time. If the scar changes color or something else went wrong, you need to see a doctor immediately.
Sports are contraindicated, you can not even do yoga, because many exercises are associated with tilting the head. But light loads and walks in the fresh air will do good. They will disperse blood and prevent the formation of blood clots. It is important to lead a healthy lifestyle, eat properly and in a timely manner.
It is necessary to take medications prescribed by a specialist. Decoctions of herbs will be good helpers in recovery, but before using them, you should consult a doctor.
Effects
This is the type of treatment that is prescribed when the lesser of two evils is to be chosen. Surgery on the skull allows you to get rid of the most complex diseases, but at the same time, a person is injured, which will accompany him all his life. The human brain has not been studied as well as we would like, because any intervention can have the most unpredictable result, namely, trepanation of the skull. The consequences of the operation may be very different or not manifest at all.
People who have undergone brain surgery are subject to increased intracranial pressure, they can not perform complex mental and physical work. Many have to change their labor activity and switch to less paid, but easier. Abandoning your usual lifestyle can be difficult.
The success of the procedure is due to many factors. Firstly, it is the severity of the disease or injury experienced by the patient, and, of course, the qualification of the surgeon. Physical health and maintaining a healthy lifestyle before surgery are also important. Smokers are most prone to postoperative complications.
Common problems
- Persistent headaches.
- Hearing impairment, vision.
- The operated area of the skull is deformed.
- Speech, behavior, thinking, memory can change.
- Impaired coordination.
- Bladder and bowel problems.
- Paralysis, cramps, weakness.
- Blood clots may form or bleeding may open.
- Possible infection or cerebral edema.
Disability
Does a person face disability after such a procedure as craniotomy? Yes. A patient who has undergone such treatment is given disability. Subject to complete recovery, it can be canceled within three years. But it should be remembered that trepanation is a complex and dangerous operation, the results of which can be very deplorable. Therefore, each case is considered individually.