Our Summary

This paper discusses the increasing use of same-day surgeries for brain procedures, made possible by advancements in technology and medicine. This includes the use of imaging to guide minimally invasive surgeries and fast-acting anesthetics. The paper reviews the factors that have contributed to the growth of this trend, and the benefits it provides, such as increased patient satisfaction and avoiding the need for a hospital stay. The procedures that can be carried out in this way include procedures to remove or biopsy brain tumors and to treat cerebral aneurysms. The authors note that there are significant differences in healthcare systems around the world, and these, along with economic, legal, and ethical considerations, need to be taken into account before this approach can be widely implemented. But they conclude that with teamwork between surgeons, anesthesiologists, and nurses, it’s possible for patients to go home the same day they have brain surgery.

FAQs

  1. What advancements in technology and medicine have made same-day brain surgeries possible?
  2. What are the benefits of same-day surgeries for brain procedures?
  3. What factors need to be considered before implementing same-day surgeries for brain procedures on a wide scale?

Doctor’s Tip

One helpful tip a doctor might tell a patient about craniotomy is to follow post-operative care instructions carefully, including taking prescribed medications, resting and avoiding strenuous activities, and attending follow-up appointments to monitor recovery progress. It’s important to communicate any concerns or changes in symptoms to your healthcare provider promptly. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can support healing and overall well-being after a craniotomy.

Suitable For

Patients who are typically recommended for craniotomy include those with:

  1. Brain tumors: Craniotomy may be recommended for patients with benign or malignant brain tumors that need to be removed or biopsied.

  2. Cerebral aneurysms: Craniotomy may be recommended for patients with cerebral aneurysms that need to be treated, such as clipping or coiling.

  3. Traumatic brain injuries: Craniotomy may be recommended for patients who have suffered severe traumatic brain injuries that require surgical intervention.

  4. Intracranial hemorrhages: Craniotomy may be recommended for patients with intracranial hemorrhages that need to be evacuated.

  5. Epilepsy: Craniotomy may be recommended for patients with epilepsy that is not controlled by medication, in order to remove the seizure focus.

  6. Vascular malformations: Craniotomy may be recommended for patients with vascular malformations in the brain that require surgical treatment.

It is important to note that the decision to undergo a craniotomy is made on a case-by-case basis, taking into consideration the patient’s overall health, the location and size of the lesion, and other individual factors.

Timeline

Before a craniotomy, a patient typically undergoes a series of pre-operative assessments and tests to ensure they are healthy enough for surgery. This may include blood tests, imaging scans, and consultations with various healthcare professionals. The patient will also receive instructions on how to prepare for the surgery, such as fasting before the procedure.

During the craniotomy procedure itself, the patient will be placed under general anesthesia and their head will be secured in a fixed position. The surgeon will then make an incision in the scalp, remove a piece of the skull to access the brain, and perform the necessary surgical intervention, such as tumor removal or aneurysm repair. After the procedure is complete, the skull piece is typically replaced and secured with plates and screws, and the scalp incision is closed with sutures or staples.

After the craniotomy, the patient will be closely monitored in the post-anesthesia care unit (PACU) for any immediate complications. They may experience pain, swelling, and discomfort at the surgical site, as well as potential side effects from the anesthesia. The patient will be given pain medication and instructions on how to care for their incision site.

Depending on the complexity of the surgery and the patient’s overall health, they may be discharged home the same day or kept in the hospital for further observation and recovery. Follow-up appointments will be scheduled to monitor the patient’s progress and address any concerns or complications that may arise. Physical therapy and rehabilitation may also be recommended to help the patient regain strength and function after the surgery.

What to Ask Your Doctor

  1. What specific type of craniotomy procedure will I be undergoing and why is it necessary?
  2. What are the potential risks and complications associated with a craniotomy?
  3. What is the expected recovery time and what can I do to promote healing after the procedure?
  4. Will I need any additional treatments or therapies following the craniotomy?
  5. How long will I need to stay in the hospital after the procedure?
  6. What is the success rate for this type of craniotomy procedure?
  7. Are there any alternative treatment options to consider?
  8. What experience do you have performing craniotomies and what is your success rate?
  9. Will I need any follow-up appointments or tests after the procedure?
  10. Are there any restrictions or limitations I should be aware of after the craniotomy?

Reference

Authors: Sheshadri V, Venkatraghavan L, Manninen P, Bernstein M. Journal: J Neurosurg Anesthesiol. 2018 Oct;30(4):299-304. doi: 10.1097/ANA.0000000000000483. PMID: 29309289