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Craniotomy For Tumor Resection

WHAT YOU NEED TO KNOW:

A craniotomy for tumor resection is surgery to remove a tumor from your brain.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.
  • Anesthesia is medicine to make you comfortable during the surgery. Healthcare providers will work with you to decide which type of anesthesia is best for you:
    • General anesthesia is used to keep you asleep and free from pain during surgery. Healthcare providers may give you anesthesia through your IV. You may breathe it in through a mask, or through a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
    • Local anesthesia is a shot of medicine placed in your scalp where the surgery will be done. It is used to numb the area and dull the pain. You may be awake during the surgery to help your surgeon monitor how you are doing. The brain does not feel pain, so you will not feel your surgeon remove the tumor. Local anesthesia is only used to prevent pain when the incision is made.
  • Pressure stockings are long, tight stockings that put pressure on your legs to increase blood flow and to prevent clots. You will wear the stockings during and after surgery.
  • Pneumatic boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots. You will wear the boots during and after surgery.
  • Antibiotics may be given through your IV during surgery to help prevent an infection caused by bacteria.
  • Anticonvulsants may be given through your IV to prevent seizures.
  • Diuretics and steroids may be given through your IV during surgery to reduce brain swelling.

During your surgery:

  • You will be sitting or lying on your side or back, depending on where the tumor is. Your head will be placed in a device to hold it steady. Healthcare providers may remove hair from your scalp where the surgery will be done. An incision will be made in your scalp over the tumor area. Holes will be drilled in your skull to remove a piece of bone. The membranes covering your brain will be cut to expose the tumor. Your surgeon will then remove the tumor.
  • Your surgeon may put implants where the tumor was. These release chemicals to kill any tumor cells that may be left. A drain may be placed in your wound to remove extra fluid from the surgery area. Your surgeon may also put in a shunt. A shunt is a drain placed under your skin that empties fluid into your abdomen. The brain membranes will be closed with stitches. The bone piece will put back in your skull and held in place with metal plates. Your surgeon will close your scalp with stitches, and then put a bandage around your head.

After your surgery:

You will be taken to a room to rest until you are fully awake. Healthcare providers will monitor you closely for any problems. Do not get out of bed until your healthcare provider says it is okay. When your healthcare provider sees that you are okay, you will be taken to the intensive care unit. The head of your bed will be elevated to help your circulation and breathing, and to decrease the pressure in your head. An MRI may be done in the first 48 hours after your surgery to check your brain. If you have a drain, it will be kept in for at least 24 hours. A bandage will be kept on your head for a day to protect your wound.

  • Vital signs are your heart rate, blood pressure, breathing rate, temperature, and pain level. Your vital signs will be checked frequently. Healthcare providers will also check your brain pressure, vision, strength, and ability to move.
  • Intake and output is how much liquid you get and how much you urinate. Healthcare providers will give you the right amount of liquids to drink or through your IV. Ask healthcare providers if they need to measure or collect your urine.
  • Activity includes range of motion exercises your healthcare provider will help you with 4 times a day. You should be able to walk around 2 or 3 days after surgery. Movement will help prevent blood clots. Do not get out of bed on your own until your healthcare provider says you can. Sit or lie down right away if you feel weak or dizzy. Then press the call light button to let healthcare providers know you need help. Talk to healthcare providers before you get up the first time. They may need to help you stand up safely.
  • A central line is an IV catheter or tube that is placed during surgery. It is put into a large vein near your collarbone, in your neck, or in your groin. You may need a central line to receive medicines or IV fluids that need to be given through a large vein. Some central lines may also be used to take blood samples.
  • A Foley catheter is a tube healthcare providers put into your bladder to drain your urine into a bag. Keep the bag below your waist. This will help prevent infection and other problems caused by urine flowing back into your bladder. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. Healthcare providers will remove the catheter as soon as possible, to help prevent infection.
  • Deep breathing and coughing should be done 10 times in a row every hour that you are awake, even during the night. This will decrease your risk for a lung infection after surgery. Take a deep breath and hold it for as long as you can. Deep breaths help open your airway. Let the air out and follow with a strong cough. Spit out any mucus you cough up.
  • Food and drink are not given for 24 hours to prevent an upset stomach. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.
  • Medicines:
    • Pain medicine is used to take away or decrease your pain. Do not wait until the pain is severe to ask for your medicine. Pain medicine can make you dizzy or sleepy. Prevent falls by calling a healthcare provider when you want to get out of bed or if you need help.
    • Steroids are used to reduce swelling in your brain. They are given through your IV.
    • Anticonvulsants are used to prevent seizures.
    • Anticoagulants are used to prevent blood clots. They are given by an injection into your skin.
    • Bowel movement softeners make it easier for you to have a bowel movement. They prevent constipation so that you do not strain to have a bowel movement. Straining may increase the pressure in your brain.
    • Antibiotics are used to prevent infection caused by bacteria. They are given through your IV for a short time after your surgery.

RISKS:

  • You may have severe pain or headache after the surgery. You may bleed more than expected or get an infection. A life-threatening infection of your brain membranes called meningitis may occur. A blood clot may form on your brain and need to be removed. Spinal fluid may leak out of your wound, ears, or nose. You may need more surgery to repair this. You may have seizures. The tumor may come back. You may have damage to your brain and nerves. This can cause paralysis or problems seeing, hearing, or talking. The pressure in your brain may go too high. This can be life-threatening.
  • Without surgery, the tumor may get larger and put pressure on your brain. This can damage your brain and cause problems with moving, talking, hearing, seeing, or thinking. You may go into a coma. These can be life-threatening.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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