Before surgery, the hair on part of the scalp is shaved and the area is cleaned. The doctor makes a surgical cut through the scalp. The location of this cut depends on where the problem in the brain is located.
The surgeon creates a hole in the skull and removes a bone flap.
If possible, the surgeon will make a smaller hole and insert a tube with a light and camera on the end. This is called an endoscope. The surgery will be done with tools placed through the endoscope. MRI or CT scan can help guide the doctor to the proper place in the brain.
The bone flap is usually replaced after surgery, using small metal plates, sutures, or wires. The bone flap may not be put back if your surgery involved a tumor or an infection, or if the brain was swollen. (This is called a craniectomy.)
The time it takes for the surgery depends on the problem being treated.
Surgery on any one area may cause problems with speech, memory, muscle weakness, balance, vision, coordination, and other functions. These problems may last a short while or they may not go away.
Blood clot or bleeding in the brain
Seizures
Stroke
Coma
Infection in the brain, in the wound, or in the skull
Brain swelling
Before the Procedure
Your doctor will examine you, and may order laboratory and x-ray tests.
Tell your doctor or nurse:
If you could be pregnant
What drugs you are taking, even drugs, supplements, vitamins, or herbs you bought without a prescription
If you have been drinking a lot of alcohol
If you take aspirin or anti-inflammatory drugs such as ibuprofen
If you have allergies or reactions to medications or iodine
During the days before the surgery:
You may be asked to stop taking aspirin, ibuprofen, warfarin (Coumadin), and any other medicines that make it hard for your blood to clot.
Ask your doctor which drugs you should still take on the day of the surgery.
Try to stop smoking. Ask your doctor for help.
Your doctor or nurse may ask you to wash your hair with a special shampoo the night before surgery.
On the day of the surgery:
You will likely be asked not to drink or eat anything for 8 to 12 hours before the surgery.
Take the drugs your doctor told you to take with a small sip of water.
Arrive at the hospital on time.
After the Procedure
After surgery, you will be closely monitored by your health care team to make sure your brain is working properly. The doctor or nurse may ask you questions, shine a light in your eyes, and ask you to do simple tasks. You may need oxygen for a few days.
The head of your bed will be kept raised to help reduce swelling of your face or head. The swelling is normal after surgery.
Medicines will be given to relieve pain.
You will usually stay in the hospital for 3 to 7 days. You may need physical therapy (rehabilitation).
Outlook (Prognosis)
How well you do after brain surgery depends on the condition being treated, your general health, which part of the brain is involved, and the specific type of surgery.
References
Gasco J, Mohanty A, Hanbali F, Patterson JT. Neurosurgey. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 68.
Review Date:
2/27/2013
Reviewed By:
Luc Jasmin, MD, PhD, Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles and Department of Anatomy, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
