Why is this procedure done?
The doctor removes part of your skull in a decompressive craniectomy. The doctor also cuts the tough protective covering over the brain called the dura. This will allow your brain to swell, without affecting the life functions controlled by your brain, like the breathing center. You may need this surgery due to: ‚
- Very serious brain injury, such as head trauma
- Stroke ¢ ˆ ’ Bleeding or blood clots in the brain
What will the results be?
Your results will depend on what you are being treated for. Talk to your doctor about what might happen. ‚
What happens before the procedure?
- Decompressive craniectomy is an emergency surgery most of the time and no special preparations are needed.
- Your doctor will do an exam and take your history. If you or a family member are able, talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- Your doctor may order:
- Blood tests
- ECG
- X-ray
- MRI of the brain
- CT scan of the brain
- PET scan of the brain
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- When you are asleep, the doctors put a tube in your mouth to help you breathe. They also put another small tube in your nose. This one goes down to your stomach to drain out any food or fluid that might come out during surgery. Your doctor will put a tube in your bladder to drain urine.
- Your hair may or may not be shaved off so the doctor can make the cut to get to the brain.
- A special device will hold your head in position for the procedure.
- The doctor will cut your scalp open to see the skull.
- The doctor drills small holes into the skull and uses a special tool to make cuts from one hole to another. The doctor takes the skull bone out so that there is room for the injured brain as it swells.
- The bone from the skull may be frozen in a special way. It may be kept until the brain swelling goes down.
- The doctor may also make cuts in the dura to make room for the brain to swell. Sometimes the doctor puts a patch over the dura so it can cover the swollen area.
- The doctor sews the scalp back in place. You will have a tube from your skull to watch the pressure in your brain after surgery. This is an ICP (intracranial pressure) monitor. This monitor helps to check how much the pressure in the skull is changing from the brain swelling.
- The surgery may last for 3 to 5 hours.
What happens after the procedure?
- You will go to the Intensive Care Unit (ICU) and the staff will watch you closely. They will check your vital signs often.
- Your doctor will test you from time to time for other signs.
- Your face or head will be swollen for a few days. You will rest with the head of your bed raised to help with swelling.
- You may have a headache for a few weeks. The doctor may give you drugs to help with pain.
- Your doctor will decide if you need more surgery to replace the bone in your skull.
- After the swelling goes down, your doctor may put the bone back in place that was removed during surgery.
What problems could happen?
- Bleeding
- Infection
- Too much spinal fluid in the brain (hydrocephalus)
- Dizziness and loss of balance
- Blood clots
- Headache that happens with higher barometric pressure
- Nerve damage
- Changes in alertness or not being able to wake up
- Convulsions or seizures
- Loss of memory, sight, smell, or hearing
- Slurred speech
- Problems breathing
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚