Craniotomy - Medical Negligence Solicitors Compensation Claims


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A craniotomy represents the surgical excision of part of the skull bone so that the brain is exposed. There are special tools used in surgery to remove the bone flap. The bone flap is either removed or kept connected and just laid back on the skull.

The craniotomy can be simple or can use computer guidance called intraoperative monitoring so that the exact location of the brain to be treated is exposed. There can be markers or a frame placed on the scalp in a procedure called “stereotactic craniotomy”. Scans made of the brain along with the markers or frame, tell the doctor the exact location where to cut the bone in a precise fashion.

There are several types of craniotomies including following:

  • Craniectomy. This is a permanent removal of a piece of skull when the bone flap cannot be replaced.
  • Endoscopic craniotomy. This uses a lighted scope with a camera to look inside the skull through a small hole.
  • “Eyebrow” craniotomy. This is done in the supra-orbital area.
  • “Keyhole craniotomy”. This is a recto-sigmoid craniotomy.
  • Translabyrinthine craniotomy.

A CT scan of the brain can be used along with the craniotomy for better placement. Other choices of imaging can be a cerebral arteriogram, EEG or electroencephalogram, x-rays of the skull or an MRI of the brain. A PET scan is used in unusual circumstances.

Why do a craniotomy? There are several reasons behind doing a craniotomy. These include the following:

  • Clipping of an aneurysm
  • Removing a brain tumor
  • Removing blood clots from a haemorrhage or leaking blood vessel
  • Removing an arteriovenous malformation, which is a collection of arteries and veins that are abnormally entwined
  • Draining a brain abscess—pus on the brain
  • Fixing skull fractures
  • Getting rid of increased pressure inside the brain
  • Repairing a hole or tear in the dura mater of the brain
  • Implanting devices to stimulate an area of the brain in diseases such as Parkinson’s disease
  • As a treatment for epilepsy

A craniotomy is not without its risks. Brain surgery is especially risky with complications the brain can’t afford to have. These include the following complications:

  • Infection of the brain or at the incision site. This can include meningitis or encephalitis.
  • Heavy bleeding, which can necessitate another surgery or can lead to death from increased intracranial pressure.
  • Blood clots forming on the brain surface.
  • Having an instable blood pressure.
  • Weakness or paralysis of muscles.
  • Intractable seizures.
  • Sweating on the brain.
  • Leakage of cerebrospinal fluid.

Some complications are specific to the area of the brain where the craniotomy was performed and include ongoing speech difficulty, memory difficulties, abnormal balance or coordination, paralysis and coma.

The craniotomy requires a 3 to 7 day stay in the hospital. It may be necessary to go to a rehab centre for several days after your hospital stay. The procedures you get depend on what was your underlying condition and the skill of your surgeon.

After the craniotomy, you will be taken to a recovery room and then transferred to the ICU for observation and further management. Your recovery depends on the type of craniotomy you had and on your underlying disease state. You will be monitored for seizures, bleeding and other complications. You may need oxygen for a period of time after the procedure. You will be taught to deep-breathe so you don’t get pneumonia. Neurological assessment will be done frequently at first and then less often as you stabilize yourself. You may have to have the head of your bed raised so as to decrease the level of pressure on your brain. Some swelling on the brain and of the face is normal and is to be expected. You may have compression devices placed on your legs to prevent blood clots from developing in the calves.

Craniotomy Medical Negligence Solicitors

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here