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A craniotomy is a surgical operation in which a bone flap is temporarily removed from the skull to access the brain. Craniotomies are often a critical operation performed on patients suffering from brain lesions or traumatic brain injury (TBI), and can also allow doctors to surgically implant deep brain stimulators for the treatment of Parkinson's disease, epilepsy and cerebellar tremor. The procedure is also widely used in neuroscience for extracellular recording, brain imaging, and for neurological manipulations such as electrical stimulation and chemical titration.
Human craniotomy is usually performed under general anesthesia but can be also done with the patient awake using a local anaesthetic; the procedure typically does not involve significant discomfort for the patient. In general, a craniotomy will be preceded by an MRI scan which provides a picture of the brain that the surgeon uses to plan the precise location for bone removal and the appropriate angle of access to the relevant brain areas. The amount of skull that needs to be removed depends to a large extent on the type of surgery being performed. The bone flap is then replaced using titanium plates and screws or another form of fixation (wire, suture, ...etc.).
Craniotomy is distinguished from craniectomy (in which the skull flap is not immediately replaced, allowing the brain to swell, thus reducing intracranial pressure) and from trepanation, the creation of a burr hole through the cranium in to the dura mater.
Complications [edit]
Bacterial meningitis occurs in approximately 0.8 to 1.5% of individuals undergoing craniotomy.[1] Postcraniotomy pain is frequent and moderate-to-severe in nature. This pain has been controlled through the use of: scalp infiltrations, nerve scalp blocks, parexocibs, and morphine - morphine being the most effective in providing analgesia.[2]
It is also common to give patients seven days of anti-seizure medications post operatively. Traditionally this has been Phenytoin, but now is increasingly Levetiracetam as it has a lower risk of drug-drug interactions. [3][4]
See also [edit]
References [edit]
- ^ van de Beek D, Drake JM, Tunkel AR (January 2010). "Nosocomial Bacterial Meningitis". New England Journal of Medicine 362 (2): 146–154. doi:10.1056/NEJMra0804573. PMID 20071704.
- ^ Hansen, Morten S; Brennum, Jannick; Moltke, Finn B.; Dahl, Jørgen B. (December 2011). "Pain treatment after craniotomy: where is the (procedure-specific) evidence? A qualitative systematic review". European Journal of Anaesthesiology 28 (12): 821–829. doi:10.1097/EJA.0b013e32834a0255.
- ^ Szaflarski, J. P; K. S Sangha, C. J Lindsell, L. A Shutter (2010). "Prospective, randomized, single-blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis". Neurocritical care 12 (2): 165–172.
- ^ Temkin, N. R; S. S Dikmen, A. J Wilensky, J. Keihm, S. Chabal, H. R Winn (1990). "A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures". New England Journal of Medicine 323 (8): 497–502.
External links [edit]
 right-parietal-craniotomy radio surgery. |  Craniotomy - Opening and Closure, Craneotomia, краниотомия (Thrace-Greece) Left occipital craniotomy for brain tumor. Intraoperative use of HILAN Pneumatic Motor System with a speed of 90.000 rpm by 8 bar (120psi) (AESCULAP-Braun Ge... |  My Awake Craniotomy My Awake Craniotomy. |  Craniotomy for tumor - Duke Samson, MD, Duke Samson, MD, UT Southwestern Medical Center at Dallas, performs a frontal craniotomy and removes a meningioma, a benign tumor. |  Pterional Craniotomy 2 iPad |  Pterional Craniotomy Columbia Neurosurgery Online Curriculum. |  Hrayr Shahinian M.D. Presents Traditional Pterional Craniotomy Hrayr Shahinian M.D. describes the traditional pterional craniotomy process through an animated video. The Skull Base Institute uses an advance endoscopic Su... |  CRANIOTOMY - New Song 2012 - AMPUTATED VEIN RECORDS Slamming Brutal Death Metal From Slovakia Album:"supply of flesh came just in time" http://www.facebook.com/pages/CRANIOTOMY/109691269053162?ref=hl http://ba... |  Craniotomy neurosurgical operation. |  Lori Conti ~ CRANIOTOMY for my BRAIN TUMOR We prepare, celebrate with friends and family and then head off to Buffalo, NY. However, the movie we prepare to see, breaks. The peaceful night of rest turn... |
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Healio
Mon, 20 May 2013 08:15:23 -0700
LA JOLLA, Calif. — A combination of methods is valuable in diagnosing cavernous sinus pathology, possibly avoiding craniotomy, and ophthalmologists may be suited to make the diagnosis, according to a poster presentation here. "While imaging studies ...
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Metal Underground
Sun, 19 May 2013 11:56:52 -0700
Slovakian brutal metal horde Craniotomy has posted an entire full album stream of its recent release "Supply of Flesh Came Just in Time," which you can hear below. This eight-song album, Craniotomy's fourth full-length, was recently unleashed via ...
| ![]() WWLP 22News |
Huffington Post
Fri, 03 May 2013 16:38:35 -0700
Regina Turner, a 53-year old former paralegal, went to the SSM St. Clare Health Center near St. Louis, to get a "left-sided craniotomy bypass" operation, the St. Louis Post Dispatch reports. Turner had begun to suffer strokes about five years ago, and ...
| ![]() Daily Mail |
Fox News
Tue, 30 Apr 2013 11:42:25 -0700
Turner was supposed to have a left-sided craniotomy bypass at St. Clare Health Center in Fenton on April 4, according to the lawsuit, which was filed in the Circuit Court of St. Louis County in Clayton. However, Turner was given a right-sided ...
| ![]() Sydney Morning Herald |
Sydney Morning Herald
Mon, 20 May 2013 22:33:18 -0700
It led to more chemotherapy and a craniotomy to remove the piece of her skull effected by the tumour. The new diagnosis meant she had to stop working again in her administrative position for a local university. She had only been back at work for six ...
| ![]() Irish Times |
Irish Times
Mon, 20 May 2013 18:01:30 -0700
The expulsion is then further defined as direct abortion, if the means used are such as to kill the foetus by the very nature of the act; as in craniotomy, for example. But it is indirect abortion, if the means used have as their immediate and direct ...
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Accident Injury Lawyer (blog)
Wed, 01 May 2013 07:30:21 -0700
Plaintiff was scheduled for a "left-sided craniotomy bypass" - instead, she received a "right-sided craniotomy surgical procedure." The second, and correct surgery, was performed six days later. The craniotomy bypass surgery was intended to prevent ...
| ![]() Science World Report |
Science World Report
Sun, 19 May 2013 20:22:10 -0700
To protect it from contusions, the surgeon will often open the patient's cranial vault – this is referred to as a release craniotomy. Until now, surgeons cut the cranial bones mechanically, that is, with a trephine. However, that approach comes with a ...
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