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Craniotomy for a Brain Bleed

Medically reviewed by Last updated on Aug 31, 2022.

What do I need to know about a craniotomy?

A craniotomy is surgery to remove part of the skull bone. This lets the surgeon fix problems in the brain. A craniotomy may be done to control bleeding and decrease pressure in the brain. Bleeding or swelling may be caused by a stroke, a blood vessel that bursts, or a head injury.

What will happen during a craniotomy?

  • The person will be given general anesthesia to keep him or her asleep and free from pain during surgery. The surgeon will make an incision in the person's head. He or she will use tools to remove part of the person's skull. He or she will also make an incision in the tissue that surrounds the person's brain (the dura). The incision will let extra fluid or blood out of his or her brain. This will help decrease pressure and prevent injury to the person's brain. The surgeon may insert tools through the incision to stop bleeding or remove a blood clot.
  • The surgeon may place a device in the person's brain tissue. The device can be used to remove blood or fluid, and decrease pressure in the skull. It can also monitor pressure inside of the person's skull. The surgeon will close the incision in the person's brain tissue with stitches. The bone piece will be put back in the person's skull and held with metal plates. The surgeon will close the person's head incision with stitches or staples. A bandage will be wrapped around his or her head.

What will happen after a craniotomy?

  • The person may have swelling and bruising. He or she may have a headache or get tired easily. He or she may also have memory problems. These signs and symptoms are normal after surgery. They should get better over time. The person's recovery time may depend on his or her injury or other conditions. It may take several weeks for the person to recover.
  • The person will be monitored in an intensive care unit (ICU) after surgery. Healthcare providers will monitor his or her vital signs and neuro signs. Neuro signs, or neuro checks, show healthcare providers the person's brain function. They will check how the person's pupils react to light. They may check his or her memory and how easily he or she wakes up. His or her hand grasp and balance may also be tested.
  • The person may need other tests and be connected to monitoring equipment. He or she may have several drains or IVs. The person may have a tube in his or her lungs that helps with breathing. Medicines will be given to keep the person relaxed, control pain, and decrease swelling in the brain.

What can be done to help the person recover in the hospital?

Follow activity instructions from the person's healthcare provider. The following are some things you can do to help the person recover:

  • Keep the head of the person's bed elevated as directed. This will decrease brain swelling and help prevent bleeding. Visitors should not lower the head of the bed unless a healthcare provider says it is okay.
  • Remind the person not to blow his or her nose. This can increase pressure in the skull and cause bleeding.
  • Remind the person not to get out of bed until healthcare providers say it is okay. He or she may need to wait until the morning after surgery or longer to get out of bed. Tell the person not to get up on his or her own. He or she may be dizzy or have problems with balance. This can increase the risk for a fall. A physical therapist may need to help the person get out of bed and walk. The person may also be given exercises to do in bed. Movement will help prevent blood clots and a lung infection.
  • Keep the person's room quiet. This will give the person's brain time to rest and heal. If his or her eyes are sensitive to light, cover the windows with blinds or turn off lights.

What are the risks of a craniotomy?

The person may get an infection or bleed more than expected. Nerves and blood vessels in his or her brain may be damaged during surgery. This may cause problems with memory, speech, balance, or movement. A craniotomy may increase the person's risk for a stroke, seizure, or coma. These problems may become life-threatening.

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