Neurosurgery

Alternative names
Craniotomy; Surgery - brain; Brain surgery

Definition
Brain surgery treats lesions of the brain and its surrounding structures through an opening (craniotomy) in the skull (cranium).

Description

The hair on part of the scalp is shaved. The scalp is cleansed and prepared for surgery. An incision is made through the scalp and a hole is drilled through the skull. A piece of the skull is removed (usually temporarily) and the surgery is performed, after which the bone is replaced and secured in place.

Indications
Brain surgery may be needed to treat:

     
  • brain tumors  
  • bleeding (hemorrhage) or blood clots (hematomas) from injuries (subdural hematoma or epidural hematomas)  
  • weaknesses in blood vessels (cerebral aneurysms)  
  • Arteriovenous malformations (AVM; abnormal blood vessels)  
  • damage to tissues covering the brain (dura)  
  • pockets of infection in the brain (brain abscesses)  
  • severe nerve or facial pain (such as trigeminal neuralgia or tic douloureux)  
  • trauma to the skull and repair of skull fractures

Risks
Risks for any anesthesia are:

     
  • reactions to medications  
  • problems breathing

Risks for any surgery are:

     
  • bleeding  
  • infection

Additional risks of brain surgery are:

     
  • injury to brain tissue  
  • injury to blood vessels  
  • nerve or muscle paralysis or weakness  
  • loss of mental functions (memory, speech, understanding)

Expectations after surgery
The results depend greatly on the underlying disease being treated, the general health of the patient, the extent of the procedure and the surgical techniques employed.

Convalescence
The recovery time varies from 1 to 4 weeks. Full recovery may take up to 8 weeks.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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