by EBSCO Medical Review Board

Definition

A craniotomy removes part of the skull to access the brain for surgery.

Craniotomy
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Reasons for Procedure

The most common reasons for a craniotomy are:

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Brain swelling
  • Heart attack
  • Damage to the brain which may cause:
    • Vision problems
    • Problems with balance
    • Bowel and bladder problems
    • Changes in memory, behavior, thinking, or speech
    • Seizures
    • Paralysis or weakness

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging for a ride to and from surgery
  • Tests that will need to be done before surgery, such as a images of the brain

Anesthesia

The doctor may give:

Description of Procedure

An incision will be made in the scalp. Part of the skull will be removed. The tissue that covers the brain will be opened. The procedure that is done next depends on the reason for the craniotomy. The tissue that covers the brain will be closed and stitched. The skull piece will be returned to its spot. Staples or stitches will be used to close the area. A bandage will be wrapped around the head.

How Long Will It Take?

It will take several hours. It depends on the reason for the surgery.

Will It Hurt?

Pain and swelling are common in the first week. Medicine and home care help.

Average Hospital Stay

The usual length of stay is 3 to 7 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give you medicine to ease pain and lower the risk of problems like blood clots and seizures
  • Take steps to prevent pressure buildup in the brain
  • Ask you to walk around to improve bloodflow
At Home

It can take a month or more to fully heal. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay return to work.

Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, such as fever and chills
  • Pain that you cannot control with medicine
  • Redness, swelling, a lot of bleeding, or any discharge from the incision
  • Headache that does not go away
  • Nausea and vomiting
  • Changes in balance, strength, or movement
  • Changes in vision
  • Loss of bladder or bowel function
  • Problems with thinking
  • Numbness, tingling, or weakness in the face, arms, or legs
  • Stiff neck

Call for medical help right away if you have:

  • Seizures
  • Shortness of breath
  • Chest pain
  • Loss of consciousness

If you think you have an emergency, call for medical help right away.

RESOURCES

American Brain Tumor Association  http://www.abta.org 

National Brain Tumor Society  http://www.braintumor.org 

CANADIAN RESOURCES

Brain Tumor Foundation of Canada  http://www.braintumour.ca 

Canadian Cancer Society  http://www.cancer.ca 

References

Craniotomy. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/craniotomy. Accessed July 20, 2021.

Lukas RV, Mrugala MM. Pivotal therapeutic trials for infiltrating gliomas and how they affect clinical practice. Neurooncol Pract . 2017 Dec;4(4):209-219. doi: 10.1093/nop/npw016.

Young JS, Chmura SJ, et al. Management of glioblastoma in elderly patients. J Neurol Sci. 2017;380:250-255.

Your surgery guide: Information about your craniotomy or biopsy for a brain tumor. Cedars Sinai Medical Center website. Available at: https://www.cedars-sinai.org/programs/neurology-neurosurgery/clinical/brain-tumor/surgery-guide.html. Accessed July 19, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 07/2021
  • Update Date: 07/20/2021