- Burr hole or keyhole—a small, dime-sized hole is made in the bone of the skull
- Awake—once the bone in the skull is opened, you are awakened from anesthesia
- Stereotactic—computer navigation is used take images of the problem area, which then guide the surgeon to the precise location in the brain through one or more burr holes
- Endoscopic—a lighted scope with a camera is inserted into the brain through one or more burr holes
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Reasons for Procedure
- Brain cancer
- Head trauma
- Blood clot in the brain
- Blood vessel problems with the brain
- Nerve disorders
- Brain swelling
- Brain infection
- Hydrocephalus treatment—insertion of a ventriculoperitoneal shunt which allows excess cerebrospinal fluid to drain into another area, usually the abdomen
- Brain swelling
Damage to your brain which may cause:
- Changes in memory, behavior, thinking, or speech
- Vision problems
- Problems with balance
- Bowel and bladder problems
- Paralysis or weakness
- Reaction to anesthesia
- Heart attack
- Blood clots
What to Expect
Prior to Procedure
- Arrange for a ride home.
- Arrange for help at home while you recover.
- Talk to your doctor about any medications, herbs, or supplements you are taking.
- Anti-inflammatory drugs
- Blood thinners
- General anesthesia—Used for most craniotomies. You will be asleep during the surgery.
- Local anethesia—Used for stereotactic craniotomies. This blocks around the surgical site from pain, but you will still be awake.
Description of Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Blood clots
- Follow your doctor’s instructions on cleaning the incision site.
- Keep your incision clean and dry.
- Ask your doctor when it is safe to shower, bathe, or soak in water.
- Continue with your physical therapist’s exercise program.
Call Your Doctor
- Any changes in physical ability, including balance, strength, or movement
- Any changes in mental status, including level of alertness, memory, thinking, or ability to respond
- Redness, swelling, increasing pain, a lot of bleeding, or any discharge from the incision
- Headache that does not go away
- Stiff neck
- Changes in vision, including double, blurred, or vision loss
- Fainting or seizures
- Numbness, tingling, or weakness in your face, arms, or legs
- Signs of infection, including fever and chills
- Persistent nausea or vomiting
- Pain that you can't control with the medications you've been given
- Difficulty breathing
- Cough, shortness of breath, or chest pain
- Trouble controlling your bladder and/or bowels
- Swelling, tenderness, hotness, or redness anywhere in your legs
American Brain Tumor Association http://www.abta.org
National Brain Tumor Society http://www.braintumor.org
Brain Tumor Foundation of Canada http://www.braintumour.ca
Canadian Cancer Society http://www.cancer.ca
Awake craniotomy treatment. University of Miami Health System website. Available at: http://neurosurgery.med.miami.edu/clinical-subspecialties/brain-tumors/awake-craniotomy-treatment1. Accessed December 3, 2013.
Brain tumor information. National Brain Tumor Society website. Available at: http://www.braintumor.org/brain-tumor-information. Accessed December 3, 2013.
Guide to the care of the patient with craniotomy post-brain tumor resection. American Association of Neurological Nurses website. Available at: http://www.aann.org/pdf/cpg/aanncraniotomy.pdf . Accessed December 3, 2013.
Hydrocephalus in children. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated February 11, 2013. Accessed December 3, 2013.
Professional Guide to Diseases. 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.
What is a craniotomy? Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/neurology%5Fneurosurgery/specialty%5Fareas/brain%5Ftumor/treatment/surgery/craniotomy.html. Accessed December 3, 2013.
6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: Michael Woods, MD
- Review Date: 12/2013 -
- Update Date: 12/00/2013 -