Emergency Craniotomy

What is an emergency craniotomy?

An emergency craniotomy is an urgent surgical procedure done to decrease pressure and alleviate swelling or bleeding in the brain, which involves the resection of a fragment of the skull to reach the brain. At the same time, the portion of the skull is returned as soon as the procedure is complete.

A craniotomy is performed to remove brain tumours and treat blood clots in the brain, vascular malformations, arteriovenous malformations, aneurysms and increased pressure or swelling in the brain.

The type of craniotomy depends on the location of the skull where the piece of bone will be removed. This could be the front part of the skull close to the hairline, the side of the skull or the part of the skull behind the ear.

How do you perform an emergency craniotomy?

On the day of the emergency craniotomy, the anaesthesiologist administers an anaesthetic to help numb pain in the area. All hair is removed from the incision site for easier, undisturbed access. An incision is made over the scalp in order to easily reach the operative site. Once the opening is made, the muscles are gently shifted. After this, several holes are drilled within the skull, and incisions are made between each of these holes to remove the segment of the skull. The piece of skull is safely stored and will be replaced once the procedure is complete. The skull fragment then fits in its original position, similar to how a piece of the puzzle fits. The surrounding muscles and tissues are carefully repositioned to their original positions, and the incision is closed. Sometime the bone flap has to be discarded if it is not safe to replace due to bone swelling. In these cases a delayed surgery, known as a cranioplasty can be done to repair this defect with a titanium mesh or bone cement.

What can I expect after an emergency craniotomy?

Directly after the procedure, you will be transferred to the intensive care unit or high care, where your condition and vital signs will be closely monitored. Furthermore, you will remain in the recovery unit until your condition stabilises.

Following the procedure and well into your recovery, you will be advised to attend follow-up appointments to monitor your progress.