Brain surgery is a big decision that’s never taken lightly. It’s done to diagnose or treat serious conditions that threaten your life or health.
Any surgery involves risks such as bleeding, infection or a complication related to the procedure itself and/or to the anaesthesia. Craniotomy also involves those short-term risks but may also involve some long-term effects as your brain recovers from its ordeal.
What is a craniotomy?
A craniotomy is a surgery that involves removing part of your skull to access your brain for various reasons, including to:
- Biopsy your brain
- Remove a tumour
- Clip or repair an aneurysm
- Remove blood or blood clots from a leaking blood vessel
- Remove an arteriovenous malformation (AVM) or address an arteriovenous fistula (AVF)
- Drain a brain abscess
- Repair a skull fracture
- Repair a tear in the membrane lining the brain (dura mater)
- Relieve pressure in the brain after an injury or stroke
- Implant stimulator devices (for example, for pain treatment or movement disorders such as Parkinson’s disease).
There are several different types of craniotomies, depending on where your surgeon chooses to access your skull.
| Type of craniotomy | Area |
| Frontal craniotomy | Front of your skull near your hairline |
| Temporal craniotomy | Between your eye and ear |
| Parietal craniotomy | Top of your skull from its mid-point to its upper back |
| Pterional craniotomy (frontotemporal) | Side of your skull, behind your temple. |
| Orbitozygomatic craniotomy | Near your eye socket and cheek |
| Supraorbital craniotomy | In the eyebrow |
| Retrosigmoid craniotomy (keyhole) | Behind your ear |
| Suboccipital craniotomy | Base of your skull, above your neck |
Different areas of your brain are responsible for particular functions like vision, motor function, balance or speech. The risks of a craniotomy vary depending on which part of your brain was operated on. Before your procedure, your surgeon should explain the risks and benefits and answer any questions you may have.
You’ll also be told what to expect next, which will usually include:
- Waking up in the intensive care unit
- Wound pain
- Common short-term side effects like headaches or nausea
- Remaining in hospital for about a week
- Recovering slowly at home for 4-6 weeks (please follow your surgeon’s advice closely).
What are the potential long-term side effects of a craniotomy?
Many people recover from a craniotomy without any complications. However, some people may experience long-term side effects.
Although it’s rare, a craniotomy may lead to changes or difficulties in the way that you:
- Speak
- Think
- Walk
- Balance and coordinate your movements
Depending on the specific location of your brain surgery, you may also experience:
- Memory difficulties
- Vision impairment
- Paralysis
That sounds scary but remember these are very rare outcomes. Your surgeon will only perform a craniotomy if the benefits are likely to outweigh the potential risks.
Recovering from brain surgery: Tips from a patient
Popular surgical dramas like Grey’s Anatomy show many patients wheeled into the OR for a craniotomy – but they never show the long, slow recovery at home afterwards.
Rest is vitally important after a craniotomy. Your brain has been through a huge experience and it needs to do less for a while so it can recover.
So, plan to rest – and to rest some more!
Learning to rest is not always easy. A former brain surgery patient suggests:
- Accepting any help that is offered
- Paying attention to your body’s signals – increased headaches and fatigue can be a sign that you’re doing too much too soon
- Going to bed – even if you don’t sleep, lying in bed gives your brain a rest from keeping you upright
- Sitting down as much as possible – e.g., when preparing food
- Using memory aids – keep a notepad and pen nearby and write down important information
- Making a medicine chart and writing down every time you take your medication to avoid missing doses or doubling up
- Setting alarms for important tasks such as taking your medicine or attending appointments.
Following your care plan is important. Don’t try to rush your recovery – it typically takes about 2 months to recover from a craniotomy. Just take things as slowly as you can, easing gently back into normal life based on your surgeon’s advice.
Reduce stress as much as you can by:
- Creating a plan for who will:
- Pick the kids up from school (you won’t be able to drive for several weeks)
- Do the grocery shopping (and unpack it)
- Cook
- Managing your frustration (you will undoubtedly be frustrated at times!) by:
- Doing some deep, slow breathing to soothe your mind and body
- Following some mindfulness practices
- Spending some time in nature
- Reminding yourself that this time will pass.
Finally, keep your follow-up appointments so your surgeon can check your progress and give you personalised advice on your recovery.
When to seek help
Call your doctor if you experience:
- Fever or chills
- Increased pain, redness, swelling, drainage or bleeding around your incision site
- Vision changes
- Confusion
- Excessive sleepiness
- Difficulty speaking
- Weakness in your arms or legs
- Trouble breathing
- Chest pain
- Anxiety or a change in mental status
- Seizures
- Phlegm that is green, yellow or tinged with blood.
For most patients, recovery from a craniotomy is quite uneventful. For some, it is a little more complicated and requires additional care and support. At Macquarie Neurosurgery and Spine, we’re here for you throughout your treatment and recovery. If you have any concerns, please contact us.
Disclaimer
All information is general and is not intended to be a substitute for professional medical advice. Macquarie Neurosurgery and Spine can consult with you to confirm if a particular treatment or procedure is right for you. Any surgical or invasive procedure carries risks. A second opinion may help you decide if a particular treatment is right for you.
References
- Macquarie Neurosurgery and Spine, Craniotomy, https://mqneurosurgery.com.au/craniotomy/, [Accessed 20 February 2024]
- Cleveland Clinic, Craniotomy, https://my.clevelandclinic.org/health/treatments/24902-craniotomy, [Accessed 20 February 2024]
- Johns Hopkins Medicine, Craniotomy, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/craniotomy, [Accessed 20 February 2024]
- Oxford University Hospitals NHS Trust, Neurosurgery: Information for patients, https://www.ouh.nhs.uk/patient-guide/leaflets/files/11585Pcranial.pdf, [Accessed 20 February 2024]
- NHS UK, Breathing exercises for stress, https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress/#, [Accessed 20 February 2024]
- Headspace, 6 ways to practice mindfulness, https://headspace.org.au/explore-topics/for-young-people/mindfulness/, [Accessed 20 February 2024]
