Cranioplasty and Craniotomy Surgery

A cranioplasty is performed to correct a deformity or defect of the skull. The deformity/defect could be congenital, as a result of trauma or acquired for example after a previous surgery involving the skull. A craniotomy is the most commonly performed surgery for brain tumour removal. It also may be done to remove a blood clot (hematoma), to control haemorrhage from a weak, leaking blood vessel (cerebral aneurysm), to repair arteriovenous malformations (abnormal connections of blood vessels), to drain a brain abscess, to relieve pressure inside the skull, to perform a biopsy, or to inspect the brain. A cranioplasty is a surgical procedure to correct a deformity or defect of the skull and it is usually performed following a traumatic injury to the skull or after a previous brain surgery such as a craniotomy or craniectomy. In order to correct the defect the physician may have to use a prosthetic or other synthetic surgical material to complete the procedure.

Steps taken:

The surgical procedure cranioplasty is performed to correct a deformity or defect of the skull. It is undertaken only after the neurosurgeon and the family accept the fact that there is a clinical issue involved due to the deformity and needs to be corrected.. There are a variety of surgical materials and prosthetics used for a cranioplasty. Your child’s neurosurgeon will review what materials will be used for your child’s specific cranioplasty procedure.

A craniotomy is performed to gain access to the brain for surgery by removing a portion of the skull. After the surgery, the bone that was removed from the skull is usually replaced using sutures or metal plates. An example of a situation where a surgeon may choose to perform a craniotomy is for removal of a brain tumour. A cranioctomy is performed when a portion of the skull is removed and replaced and in craniectomy the portion of the skull is removed but not immediately replaced. Some examples of situations where a surgeon may choose to perform a craniotomy are: to create room for the brain to swell after trauma, to remove the bone due to an infection in the skull or a severely damaged skull with multiple fragments.

Advantage:

Early cranioplasty is helpful for improvement of neurological functions of patients craniotomy helps to correct the skull deformities at young age which can help for rest of the life for the patient. These are precise and farily accurate with minimum incision.

Precautions :

Immediately following craniotomy, it usually takes at least 6 weeks for the bone to completely heal. any activity that may risk a hit to the head or fall are completely prohibited as the skull bone takes long time to heal and any physic injury could be life-threatening. Wearing a protective helmet is recommended. Only gentle washing is recommended. Scrubbing, oiling etc. is to be avoided completely. Patients discharged only when they are able to eat a regular diet, well managed on oral pain-relieving medications and there are no complicating health issues prevailing at the time of discharge. Any a change in the patients behaviour, vomiting episodes, fever, drainage/redness/swelling at the surgical site, seizure and pain are to be observed and doctor must be contacted immediately.

FAQs

What is the difference between a craniotomy and craniectomy?

Both procedures involve removing a portion of the skull, usually to perform surgery on the brain. The difference is that after a craniotomy the bone is replaced and after a craniectomy the bone is not replaced immediately.

What is the waiting period until the bone flap is replaced?

The bone flap is replaced after adequate time to heal. Your neurosurgeon will decide when the bone flap can be replaced but most often that decision is made when it is safe in order to reduce the risk of infection. Bone flaps are usually replaced 1 - 3 months after the craniectomy.

Will my child need further surgery as the head grows?

Not usually. Your child will have several follow-up appointments after surgery to ensure that everything is healing appropriately. It is usually not necessary to replace the cranioplasty materials as your child grows.

When can the bone flap be stored and replaced? When are synthetic materials necessary?

This is usually decided by your child’s neurosurgeon on a case by case basis. However, if there is infection or the bone was damaged, synthetic materials will usually be chosen for the cranioplasty.

After a cranioplasty Will my child’s head look the same after the surgery as pre-injury?

Your child’s head should have an appearance very similar to how your child looked pre-injury. Your child will still have a scar at the incision for the cranioplasty site.