Craniotomy: Surgery, Procedure, Cost, Side Effects, Risks, & Recovery
Craniotomy is a medical operation that removes a bone flap from the skull or cranium to treat the bone area. The bone flap is replaced and covered with smallscrews and plates during the surgical procedure. A procedure where the bone flap is intentionally not replaced is known as craniectomy. Here you will know details about craniectomy surgery, cost, risk, recovery etc.
It is a surgical procedure that treats brain aneurysms, head injuries, blood clots, or brain tumors. Craniotomy surgery can be minor or large depending on the severity of the brain damage. It is a complex surgery, and it is often selected by neurosurgeons to treat brain lesions, remove foreign pieces such as bullets, and treat traumatic brain injuries. Craniotomy is a widely chosen treatment option due to its minimally invasive nature. Around 48% of patients are treated using the craniotomy surgical procedure.
Types of Craniotomy
- Extended Bifrontal Craniotomy: It is used for challenging tumors that are located in the front of the brain. A neurosurgeon makes an incision in the scalp and aims to remove the bone around the orbits and forehead during this procedure. This procedure is performed to treat meningiomas, esthesioneuroblastomas, and malignant or cancerous skull base tumors.
- Minimally Invasive Supra-Orbital Craniotomy: A neurosurgeon makes a small incision within the eyebrow to target tumors in the front of the brain or around the pituitary gland. This procedure has several benefits, such as less pain, faster recovery, and minimal scarring compared to an open craniotomy. This procedure is performed to treat Rathke’s cleft cysts, skull base tumors, and pituitary tumors.
- Retro-Sigmoid “Keyhole” Craniotomy: A minimally invasive procedure designed for the eradication of brain tumors. This procedure provides access to the cerebellum and brainstem by making a small incision behind the ear. This procedure is performed to treat meningiomas, acoustic neuromas, skull base tumors, and metastatic brain tumors.
- Orbitozygomatic Craniotomy: This is a traditional method used for challenging tumors and brain aneurysms. A neurosurgeon makes an incision behind the hairline and removes bone around the orbit and cheek during this procedure. This procedure allows for the temporary removal of bones to access deeper parts of the brain. This procedure is performed to treat craniopharyngiomas, pituitary tumors, and meningiomas.
- Translabyrinthine Craniotomy: A neurosurgeon makes an incision behind the ear to remove the mastoid bone and inner ear bone. This procedure is used for acoustic neuromas where hearing loss is acceptable or inevitable. This procedure gives access to tumors while lowering the risk of facial nerve injury.
Symptoms of Craniotomy
- Headache
- Vomiting and experiencing nausea
- Swelling and bruising around the location of the incision
- Stiff neck
- Loss of hearing or vision
- Muscle weakness or lack of sensation in the arms or legs
- Struggle to understand or speak
- Changes in cognitive functions, such as issues with memory or confusion
- Brain seizure
- Infection at the site of the surgical procedure
- The leaking of cerebrospinal fluid
- The formation of blood clots or heavy bleeding
Causes of Craniotomy
Craniotomy is performed to remove brain tumors. It also helps in treating brain aneurysms. This procedure relieves pressure inside the skull, which is caused by a head injury. Craniotomy is used to stop brain bleeding or hemorrhage. This procedure is also done to remove parts of the brain that cause seizures or epilepsy. Brain abscesses are also drained using a craniotomy. Craniotomy allows access to deep brain stimulation for Parkinson’s disease. Skull fractures with brain damage can also be repaired with a craniotomy. Some neurological conditions, such as AVMs, are treated with craniotomies. Craniotomy corrects abnormalities or deformities in the skull and face.
Diagnosis for Craniotomy
- Craniotomy is diagnosed through advanced imaging tests such as CT scans or MRIs. These imaging tests reveal brain abnormalities or deformities.
- The neurosurgeon will perform neurological examinations. They are conducted to evaluate the cognitive function and physical symptoms related to the brain.
- Biopsies of brain lesions are performed to confirm diagnoses before proceeding with craniotomy. This confirmation helps in the precise treatment of various brain conditions.
- The neurosurgeon will carefully review the medical history or prior head injuries or neurological disorders.
Treatment Options for Craniotomy
- Traditional Craniotomy: The neurosurgeon initially makes an incision in the scalp, then removes a bone flap from the skull to operate the brain. This procedure gives direct access to the brain for procedures such as tumor removal, aneurysm repair, or epilepsy surgery.
- Keyhole Craniotomy:This is also known as a minimally invasive craniotomy. During this procedure, a neurosurgeon makes a smaller incision and uses specialized tools to operate the brain through a smaller opening in the skull. Keyhole craniotomies are preferred for less invasive procedures like biopsy or the removal of small tumors.
- Stereotactic Craniotomy: The neurosurgeon performs imaging techniques such as MRI or CT scans before this treatment option to precisely locate the area of the brain needing surgery. Stereotactic craniotomies allow surgeons to precisely target lesions or tumors while minimizing damage to neighboring healthy tissue.
- Endoscopic Craniotomy: This procedure uses a thin and flexible tube with a camera attached (an endoscope) to operate the brain through small incisions in the scalp or nasal passages. Endoscopic craniotomies are preferred for procedures like pituitary tumor removal or the treatment of hydrocephalus.
- Awake Craniotomy: The patient remains awake and alert during this procedure. This procedure allows the surgical team to monitor neurological function in real-time. Awake Craniotomy is useful in operating areas of the brain that control speech or movement. Awake craniotomies are preferred for tumor resection or epilepsy surgery.
- Craniotomy with Navigation: Navigation systems use advanced imaging techniques and computer software to create a three-dimensional map of the patient’s brain. This procedure helps neurosurgeons precisely direct to the target area. This procedure enhances the accuracy and safety of the procedure.
Risks Associated with Craniotomy
- Infection risk caused by fungus or bacteria.
- There is a possibility of heavy bleeding, either during or after the surgical procedure.
- The formation of blood clots in the brain or among the arteries that surround it.
- Brain swelling after surgery
- Seizures are an unwanted side effect of brain surgery.
- There is a possibility of neurological dysfunction that is either temporary or permanent.
- Cerebrospinal fluid is leaking from the site of the surgery.
- There is a risk of stroke due to damage to vessels or decreased blood flow.
- There is a possibility of cognitive changes, such as difficulty remembering.
- Anesthesia-related adverse reactions
Craniotomy Cost in India
Craniotomy cost in India vary due to different factors such as the doctor’s fees, the treatment option opted for, and the hospital where the surgery takes place. This cost range of USD 4800 to USD 5800 covers the hospital stay of approximately 7–10 days.
Craniotomy Success Rate in India
The craniotomy success rate in India ranges from 96 to 98%. This high success rate suggests that most surgeries are successful in removing tumors or treating other brain conditions. The success rate of craniotomies in India is influenced by the size of the tumor being treated.
Top Hospitals for Craniotomyin India
- Fortis Memorial Research Institute, Gurgaon
- Artemis Hospital, Gurgaon
- Indraprastha Apollo Hospital, New Delhi
- Gleneagles Global Hospital, Chennai
- BLK Super Speciality Hospital, New Delhi
- Max Super Speciality Hospital, Saket, New Delhi
- Kokilaben Dhirubhai Ambani Hospital, Mumbai
- Medanta – The Medicity, Gurgaon
Best Doctors for Craniotomyin India
- Aditya Gupta – Artemis Hospital, Gurgaon
- Mohit Bhatt – Kokilaben Dhirubhai Ambani Hospital, Mumbai
- Rajiv Anand – BLK Super Speciality Hospital, New Delhi
- Praveen Gupta – Fortis Memorial Research Institute, Gurgaon
- Puneet Agarwal – Max Super Speciality Hospital, Saket, New Delhi
- Atma Ram Bansal – Medanta – The Medicity, Gurgaon
- Abhaya Kumar – Kokilaben Dhirubhai Ambani Hospital, Mumbai
- Dinesh Nayak – Gleneagles Global Hospital, Chennai
- Mukul Varma – Indraprastha Apollo Hospital, New Delhi
- Sandeep Vaishya – Fortis Memorial Research Institute, Gurgaon