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Craniotomy

A procedure to remove a lesion in the brain through an opening in the skull.

A type of brain surgery.

A surgical operation in which a bone flap is temporarily removed from the skull to access the brain.

Most commonly performed surgery for brain tumor removal.

The procedure may be performed for the removal of a hematoma, to control hemorrhage from a cerebral aneurysm, to repair arteriovenous malformations), to drain a brain abscess, to relieve pressure inside the skull, to perform a biopsy, or to inspect the brain.

Craniotomies often performed on patients suffering from brain lesions or traumatic brain injury (TBI).

Allows for the surgical implantation of CNS stimulators for the treatment of Parkinson’s disease, depression, epilepsy and cerebellar tremor.

Usually performed under general anesthesia but can be also done with the patient awake using a local anesthetic.

Procedure generally does not involve significant discomfort.

Usually preceded by imaging studies such as an MRI scan which provides information about the brain that the surgeon uses to plan the precise location for bone removal and the appropriate angle of access to the relevant brain areas.

The extent of skull removed depends on the type of surgery being performed.

The bone flap is then replaced using titanium plates and screws or fixated by wire, or sutures.

Craniectomy is a procedure that the skull flap is not immediately replaced, allowing the brain to swell, thus reducing intracranial pressure.

Bacterial meningitis occurs in approximately 0.8 to 1.5% of individuals undergoing craniotomy.

Postcraniotomy pain is frequent and moderate-to-severe in nature.

To reduce risk of seizures, anti-seizure medications are given one week post operatively.

Methods commonly utilized by surgeons to open the skull are either an incision made at the nape of the neck around the bone at the occipital bone or a curved incision made in front of the ear that arches above the eye.

Following the incision, the scalp tissue is folded back to expose the bone and by using a high-speed drill, a pattern of holes are made and connected by a fine wire saw, until a bone flap can be removed.

At the completion of the procedure the bone is replaced and secured into position with wire, and muscle, and skin are sutured into position.

The use of anticoagulants and platelet function inhibitors have been correlated with an increase in blood clot formation after surgery, and these medications are discontinued at least seven days before the surgery to reverse any blood thinning

National average mortality 10.7%.

Nosocomial bacterial meningitis occurs in 0.8-1.5% of cases (Korinek AM).

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