Definition
A craniotomy removes part of the skull to access the brain for surgery.
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Reasons for Procedure
The most common reasons for a craniotomy are:
- Brain biopsy
- Brain cancer
- Head trauma
- Blood clot in the brain
- Blood vessel problems with the brain
- Nerve disorders
- Brain swelling
- Brain infection
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:
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:
- Local anesthesia—the area will be numbed
- General anesthesia—you will be asleep
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
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
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