Awake craniotomy is performed in the same way as conventional craniotomy , but the patient is awake during the operation. This is the most preferred technique to remove lesions located near or with functionally important regions of the brain. Craniotomy in consciousness testing area before removing the tumor allows to continuously check the function of the brain. The main task - to minimize the risks of surgery.
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How is the awake craniotomy?
There are various methods, but are most often used is described below.
The patient is put a dropper, introduce products that will make him feel comfortable and relaxed. Typically, patients experience minimal discomfort during craniotomy in consciousness, or lack thereof.
Then used neuronavigation system that mark the incision site. Along the line to shave a small amount of hair, the skin is cleaned with an antiseptic solution, then a local antiseptic injected around the incision.
Wound drape, but the patient has the opportunity to see the team of anesthetists, talk with them, move your arms and legs during surgery. The operation continues, the patient hears certain sounds, including sounds of the drill for a while.
After the discovery of the brain performed a procedure called cortical mapping. It involves stimulation of the brain surface through tiny electric probe. If affected:
- motor area, there twitching limbs or face;
- touch area - there is tingling;
- speech area - the patient will speak very briefly.
Identifying important regions of the brain, doctors seek to protect them during the operation. During the removal of the tumor being tested all functions of the brain. If there are changes, the neurosurgeon stops. All this does not exclude the risk of surgery, but reduces it.
Once the tumor is removed, the bleeding was stopped, the dura is closed via sutures, bone is replaced by 3 mini-plates scalp fixed seams.
Suitable using general anesthesia
Also, the operation can be started when a patient is deeply asleep. Such an approach is sometimes used for the comfort and safety of the patient. After the discovery of the brain reduces the dose of anesthesia, allowing the patient to regain consciousness, begin to speak, move and interact with physicians.
After tumor resection, spinal anesthesia is used, which allows to complete the operation safely, without discomfort to the patient.
What happens after craniotomy under local anesthesia?
Post-operative recovery is faster because it does not use the general anesthesia. Likely to be applied only dropper without the catheter and other devices. The patient can eat, drink, walk, once feel that it is able to do so. It may be discharged on the day of surgery or the next day. After 4 hours after the surgery is performed CT if good condition - after 6 hours the patient can be discharged.
What happens after discharge?
After craniotomy requires several weeks in mind to fully recover. The first fourteen days may experience headaches, which are monitored by simple painkillers. The patient will feel fatigue need extra rest. However, the need to be simple daily exercise such as walking.
5-7 days after surgery, the patient meets the doctor who checks the state of recovery, provides the results of a biopsy after surgery. Consults on further assistance, answers to any questions.
What should notify the physician after craniotomy in the mind?
It is necessary to report the following symptoms:
- of headaches, gradually progressing;
- of fever;
- of seizures;
- problems with wound (increasing pain, swelling, secretions);
- the emergence of new or worsening of existing symptoms (weakness, numbness, etc.);
- an increase drowsiness;
- about rashes.
What are the risks awake craniotomy?
Risks associated with operations in the mind are the same as for a regular trepanation, but there is little likelihood of convulsions during craniotomy in the mind, in rare cases there is a need to appeal to general anesthesia.
All surgery carries a risk. In general, complications are rare after craniotomy. The degree of side effects depends upon a number of factors:
- tumor size;
- its localization and type;
- general state of health;
The surgeon will tell about the risks associated with the operation, and will give an idea of the potential complications. These include:
- temporary or permanent neurological deficit (stroke) - paralysis or loss of speech;
- brain edema;
- Cerebrospinal fluid leakage;
- general medical complications;
- deep vein thrombosis;
- pulmonary embolism;
- heart attack;
- urinary tract infections.
Some of these side effects may be serious enough to justify further operation, a number of them - are life-threatening. In general, information as a general guide - the rate of serious complications that cause neurological deficit (stroke) or death is 5%.
General risks of complications such as deep vein thrombosis or infection - are less frequent, because it does not use general anesthesia.