Awake Craniotomy
Awake Craniotomy
What is it:

Awake brain surgery is a sort of procedure performed whereas you are attentive to treat some brain conditions, as well as some brain tumors or epileptic seizures. If your growth or seizure center is close to the part of your brain that manages vision, movement or speech, you will be awake throughout surgery to retort to your doctor. Your responses facilitate your doctor to make sure that he or she treats the precise space of your brain needing surgery. Additionally the procedure lowers the chance of harm to functional areas of your brain

Before the operation:
  • To prepare for the surgery, tests are ordered by the doctor for some days before the procedure. These tests embrace blood tests, chest x-ray as a brain scan by imaging, CT scan or PET
  • The patient must not take medicines or blood thinners, for a minimum of one week before the procedure. The doctor could dictate medications to require before surgery to get rid of anxiety and/or stop procedure swelling, infection or seizures after the surgery
  • The patient ought to stop smoking, tobacco and drinking alcohol for one to two weeks before the surgery since these are known to cause complications throughout and once surgery and thereby retardation down the healing process
  • The patient do not eat or drink anything for a minimum of eight to twelve hours before the procedure
  • Before the procedure, the patient’s head is shaven over the area wherever the operation is done. The scalp is typically shaven with the type of a little horse-shoe
The operation:
  • No food or drink is allowable in midnight or the night before surgery. Patients are admitted to the hospital in the morning of the surgery. An intravenous line placed in your arm, anesthesia is run whereas you lie on the table
  • Once asleep, your head is placed during a 3-pin skull fixation device that attaches to the table and holds your head in position throughout the procedure
  • Insertion of a lumbar drain in your lower back helps take away cerebrospinal fluid, so permitting the brain to relax throughout surgery. A brain-relaxing drug referred to as water pill could also be given
  • After the scalp is prepped with an antiseptic, a skin incision is created, typically behind the hairline. The doctor tries to make sure an honest cosmetic result after surgery. Generally a hair sparing technique may be used that needs shaving solely a 1/4-inch wide space on the planned incision. Generally the complete incision space could also be well-shaven
  • The skin and muscles are upraised off the bone and rolled-up back. Next, one or additional little burr holes are created within the skull with a drill. Inserting a special saw through the burr holes, the doctor uses this craniotome to cut the define of a bone flap
  • The cut bone flap is upraised and removed to reveal the protecting covering of the brain referred to as the dura. The bone flap is safely hold on till it's replaced at the top of the procedure
  • After opening the dura, the doctor folds it back to reveal the brain. Retractors placed on the brain gently open a passageway to the realm needing repair or removal. Neurosurgeons use magnification glasses referred to as loupes or a binocular microscope to envision the fragile nerves and vessels
  • With the matter removed or repaired, the retractors holding the brain are removed and therefore the dura is closed with sutures. The bone flap is replaced back in its original position and secured to the skull with metal plates and screws
  • The plates and screws stay permanently to support the area; these will generally be felt beneath your skin. In some cases, a drain could also be placed beneath the skin for some of days to get rid of blood
After the operation:
  • After the operation you're transferred to the neurobiology medical aid unit for close observation and watching. You are commonly asked to move your arms, fingers, toes and legs
  • Hospital stay is 3 days or 2 weeks reckoning on the surgery and development of any complications. Once discharged from the hospital, you’ll incline discharge directions. Stitches or staples are removed 7–10 days when surgery within the doctor’s workplace
  • After surgery, headache pain is controlled by pain killers. As a result of narcotic pain pills are habit-forming; they're used for a restricted amount. Their regular use may additionally cause constipation, therefore drink quantity of water and eat high fiber foods
  • Do not drive after surgery till mentioned by your doctor and avoid sitting for long periods of your time
  • Do not raise anything heavier than five pounds like 2-liter bottle of soda as well as small children. Do not drink alcoholic beverages
  • Gradually come back to your traditional activities. An early exercise program to carefully stretch the neck and back is also suggested
  • Walking is good beginning with short walks and bit by bit increase the area. Wait to participate in alternative sorts of exercise till mentioned by your doctor
  • You can shower and shampoo three to four days when surgery is done
  • The recovery time varies from one to four weeks reckoning on the underlying illness being treated and your general health. Full recovery can take up to eight weeks. Walking may be a great way to start increasing your activity level. Begin with short, frequent walks at intervals the house and bit by bit strive walks outside. It’s vital to not make it, particularly if you're continued treatment with radiation or therapy
Possible complications:
  • General complications of any surgery embody hurt, infection, blood clots and reactions to anesthesia. Specific complications associated with a surgery might include
  • Stroke, seizures, swelling of the brain which can need a second surgery
  • Nerve injury which can cause muscle palsy or weakness
  • CSF leak which can need repair
  • Loss of mental functions
  • Permanent brain injury with associated disabilities