Craniotomy: recovery after surgery

A craniotomy is a complex surgical intervention that involves making an artificial hole in the bone to access the brain. Complications may occur in the process, some of which do not depend on the skill of the surgeon and can lead to disability or death of the patient. And even if everything goes well, recovery after craniotomy will be long and will require the patient to strictly comply with the requirements of the attending physician.

Scope of operation

The surgical intervention affecting the brain is so serious that it is carried out in a single case - if not just a person's health is at stake, but his life. Trepanation is prescribed:

• if a neoplasm matures in the patient's brain - even if it is in no way connected with oncology, as it grows, it will compress parts of the brain, cause monstrous migraines and hallucinations, making a normal life almost impossible;
• if cancer develops in the patient's brain - as the neoplasm develops, it will not only compress neighboring sections, but also affect them with metastases, which can lead to disability, and subsequently death;
• if an inflammatory infectious process occurs in the patient’s brain, the further it goes, the greater the likelihood of irreversible damage that will lead to the failure of certain departments and, accordingly, body functions;
• if the patient's skull was damaged due to a traumatic brain injury, trepanation can be performed to extract bone fragments, assess the damage and, if possible, compensate for it;
• if the patient has experienced a stroke provoked by thrombosis, trepanation is performed to remove the clot that has plugged the vessel;
• if the patient suffers from thrombosis and the risk of stroke is very high, trepanation is performed to remove blood clots;
• if the patient suffers from cerebral bleeding, provoked by a sudden rupture of the vessel, trepanation is designed to give the doctor access to the brain and the ability to cope with bleeding;
• if there is a suspicion of brain cancer and a biopsy is needed, trepanation opens the brain so that tissue samples can be taken from it.

For less serious reasons, trepanation is not performed - as long as possible, doctors always strive to do without such a serious intervention. Their efforts are especially great if the patient's chances of surviving the operation without complications are not too high.

Factors that increase the risk of complications

Craniotomy always comes with a certain risk of complications, but there are factors that can significantly increase it - as well as the risk of complications in the recovery period. To somehow compensate for this, it should be borne in mind that the following are in danger:

1. Elderly people. Worn-out vessels of the heart and brain may not withstand the load under general anesthesia, reduced vitality and metabolic rate can significantly affect the success of the recovery process, concomitant diseases (and in old age they develop even in the most healthy and successful people) can affect the outcome of the operation.
2. Children. The compensatory mechanisms of the child's body are not yet sufficiently developed, as is his immunity, therefore any surgical intervention poses a significant risk for children. In addition, it is impossible to explain to a small child the need to comply with the regime after a craniotomy; he can harm himself.
3. People who have already experienced surgery on the skull. Often, after the first operation, adhesions are formed between the membranes of the brain and its substance, which are pressed against the part of the bone that was once opened. With repeated intervention, there is a high risk of damaging the entire structure.
4. People suffering from blood diseases. Hemophilia, anemia - any diseases that affect the rate of blood clotting significantly increase the likelihood of bleeding during surgery and add problems in order to somehow compensate for it.
5. People suffering from diabetes. Due to the specific features of this disease, all blood vessels are damaged to one degree or another, which greatly complicates the recovery period.
6. People suffering from any immune deficiency syndromes. If they are present, the likelihood of developing an infectious inflammatory process as a result of surgery increases significantly. If possible, doctors avoid prescribing craniotomy to patients in this group - but if it is still necessary, great efforts are needed to compensate for the disease.

However, even if a person is completely healthy, the recovery process will be long and it will not be possible to insure against the development of complications.

Possible Complications

There are two options for complications that can develop in a patient who is assigned for surgery:

1. Early. Their occurrence occurs directly during the intervention and often does not even depend on the skill of the surgeon. Among them:

• Bleeding. Since the brain has an abundant blood supply, the loss will be rapid and profuse, which is why surgeons always have blood ready for transfusion.
• Damage to the brain. At the current level of medical development, they are rare, but can lead to complete failure of the affected area of ​​\u200b\u200bthe brain.
• Edema. It is with them that the brain reacts to any emergency situation. With inaccurate trepanation, a displacement of the medulla to the area of ​​intervention is possible - often with pathologies and ruptures.
• Death. It can develop for a variety of reasons, up to simple heart failure due to anesthesia and the excessive load caused by it.

1. Late. Their occurrence should be expected after trepanation, during the recovery period. They can be provoked by non-compliance with the recommendations of the doctor, an inaccurate operation and weakness of the body after the intervention. Among them:
2. Wound infection. If hygienic standards were not adhered to strictly enough, there is a chance that the edges of the wound will become inflamed and swell, causing pain to the patient.
3. brain infections. They are very rare, but have severe consequences, provoking forgetfulness, irreversible personality changes, convulsions, failures of certain departments.
4. Thrombi and blood stasis. After the operation, a person usually does not move much, because there is a high probability of developing thrombosis, which already threatens with its own complications, up to strokes and heart attacks.
5. neurological disorders. Brain tissues can swell, which will disrupt the work of its departments. A person may experience problems with everything from speech to coordination - permanent or temporary, depending on the extent of the lesion.

Also, the patient may feel depressed, experience problems with sleep and appetite, suffer from speech and coordination disorders, and may become irritable or whiny. The main thing is to carefully monitor any suspicious symptoms and, while rehabilitation after a craniotomy lasts, carefully report them to your doctor.

There are no unimportant symptoms - if something causes anxiety in the patient, it should be talked about.

Recovery period in the hospital

Even if the operation was completely successful, the patient is left in the hospital to observe and compensate for the consequences of the intervention for a week. During this time:

1. On the first day. For the first few hours, while the patient is recovering from anesthesia, an oxygen mask remains on him, catheters are connected to the arm, fixing the pulse and supplying a nutrient solution to the vein, and a sensor that fixes intracranial pressure is connected to the head. As soon as the patient wakes up, the doctor assesses his general condition, how well he has coordination, whether he is adequate. The mask is removed, and the catheters are removed.
2. On the second day. The patient is allowed to rise and independently get to the toilet. The drainage is removed, it is allowed to eat independently if the patient feels capable of it. His face is still bruised and swollen.
3. On days three through seven. The patient restores the basic functions of the body, bruises and swelling are slowly disappearing, doctors are closely monitoring his condition. If there are suspicions of complications, they try to stop them at the very beginning.
4. On the seventh day. They remove the staples that remained after the trepanation and, having given the patient all the necessary prescriptions, they discharge him home.

All the time, while there is a recovery after a craniotomy operation, the patient can receive the following medications:

• painkillers - they allow you to relieve constant pain in the wound on the head;
• anti-inflammatory - they can reduce the likelihood of developing infectious complications almost to a minimum;
• sedatives - they allow you to provide the patient with a constant calm and even mood, which is useful, because he should not be nervous;
• anticonvulsant and antiemetic - they allow you to save the patient from unpleasant side effects;
• steroid - they remove unnecessary water from the body, which leads to a decrease in pressure.

In addition, every day the wound is treated, which is necessary so that it does not become inflamed and does not fester. In addition to medicines, the patient is usually prescribed:

1. Diet. A weakened body should spend all its energy on recovery, and not on digesting food, because in the first week, hospital food is usually as easy to digest as possible. Boiled and mashed potatoes, compotes and jelly, some bread. Often a combination of drugs can cause constipation in a patient, and then he is advised to drink more.
2. Breathing exercises. With a sedentary lifestyle, the lungs always suffer, therefore, from the very first day, the patient is shown a set of exercises that he must perform lying down - usually these are various inhalations and exhalations.

In the first week, you can not actively move and be nervous. Only rest and medical supervision allow you to recover enough for discharge.

Recovery period at home

Even after a successful operation, you need to pay a lot of attention to the recovery period - it should last at least six months. Should:

• Give up bad habits - they can provoke problems.
• Do not lift weights - loads of more than three kilograms are completely contraindicated.
• Refrain from nervous unrest - if it does not work, you should drink a course of soothing herbs. If they do not have an effect, this may be evidence of a developing neurological disease and you should consult a doctor.
• Refrain from tilting - if you need to lift something, it will be better to sit down.
• Walk - every day, at a not too fast pace. It is advisable to choose a quiet place for walking, away from the hustle and bustle of the city. A shady park or a small grove will do.
• Stick to a diet - Proper nutrition is very important for normal recovery.

If the craniotomy is successful, the recovery period allows the patient to return to full life in a relatively short period of time. The main thing is to listen to the doctor, monitor the state of your health and not rush anywhere.