The thought of being awake while a surgeon is operating on your brain strikes some people as akin to medieval torture. But the reality is quite the opposite. Because the brain doesn’t have any nerves/pain receptors, the patient feels nothing. But in certain brain surgeries, patient involvement is very helpful in locating areas such as those governing speech or movement and avoiding them.
At Texas Neurosurgery, our expert surgeons perform craniotomies for various conditions. In some of these, the patients are awake, while in others they are under sedation.
What is a craniotomy?
A craniotomy is a surgical procedure where part of the skull is removed to view and gain access to the brain. The portion of the skull that is cut away is known as the “bone flap.” The surgery is named for the bone at the spot where the skull is cut out. These are called frontotemporal, parietal, temporal, or suboccipital craniotomies. Once the surgery is complete, the bone flap is fitted back into the skull, and it will grow back together. In some cases, all that is required is a minimally invasive dime-sized incision in the skull. This is called a keyhole craniotomy.
What is a craniotomy used to correct?
Our surgeons at Texas Neurosurgery perform craniotomies to address a variety of conditions:
- Diagnosing/removing/treating brain tumors, including meningiomas
- Removing blood clots or blood, including subdural hematomas
- Repairing tears in the membrane that lines the brain
- Repairing or clipping aneurysms
- Draining brain abscesses
- Removing arteriovenous malformations
- Repairing skull fractures
- Treating epilepsy
- Implanting stimulator devices to treat movement disorders
- Relieving pressure within the brain caused by trauma or stroke
How is a craniotomy done?
With the patient sometimes under general anesthesia and sometimes not, an incision is made at the treatment spot. The bone flap is removed to provide access to the brain. In some cases, patients are awake, and they provide guidance at this point. The patient may be asked to move his or her legs, to recite the alphabet, to tell stories, or asked to perform other actions to be sure the area of the brain being entered will not adversely affect something like the patient’s ability to speak. At this point, the surgeon will close the connection between a blood vessel and an aneurysm with a small clip, will remove all or part of a tumor, will remove a blood clot, drain an abscess, or relieve pressure on the brain.
Once the surgery is complete, the bone flap is replaced, and the scalp is stitched together. The bone flap is usually fixed into place with small metal screws to prevent movement and encourage better healing.
If you suffer from a serious condition such as an aneurysm or brain tumor, rely on the expert surgical team at Texas Neurosurgery. Call us at 214-823-2052 to make an appointment, or with any questions, you may have.