Craniotomy

In the hospital

Right after the procedure, you will be taken to a recovery room to be closely watched. This is before being taken to a regular room or to the intensive care unit (ICU). In some cases, you may be taken directly to the ICU from the operating room. In the ICU, you may be given medicine to decrease the brain swelling.

You may have in place a brain intracranial pressure (ICP) device to keep track of the pressure in your brain. Or you may have an external ventricular drain to remove extra cerebrospinal fluid (CSF). These devices are often removed after a few days.

You may have a few catheters to get or drain fluid, or to keep track of your blood pressure.

Your recovery will vary depending on the type of procedure done and the type of anesthesia you had. Once your blood pressure, pulse, and breathing are stable and you are alert, you may be taken to the ICU or your hospital room.

You will move to a room in the hospital after staying in the ICU and your condition is stable. You will stay in the hospital for a few more days.

You may need oxygen for a while after surgery. Generally, the oxygen will be stopped before you go home.

You will be taught deep-breathing exercises. These will help to re-expand the lungs and prevent pneumonia.

Medical staff will check your brain function often and make sure your body systems are working correctly after surgery. To check your brain function, you will be asked to follow a variety of basic commands. These include moving your arms and legs. Your pupils will be checked with a flashlight, and you will be asked questions to assess your awareness. These might include your name, the date, and where you are. The staff will test the strength of your arms and legs.

The head of your bed may be raised to prevent swelling of your face and head. Some swelling is normal.

You will be encouraged to move around as you are able while in bed. As your strength improves, you will have help to get out of bed and walk around. A physical therapist (PT) may evaluate your strength, balance, and mobility. The PT will give you suggestions for exercises to do both in the hospital and at home.

You will likely have sequential compression devices (SCDs) placed on your legs while you are in bed to prevent blood clots. SCDs have an air compressor that slowly pumps air into and out of fitted sleeves that are placed on the legs. They help prevent blood clots by passively compressing the leg veins to keep blood moving.

You may be given liquids to drink a few hours after surgery. This depends on your case. Your diet may be slowly changed to include more solid foods, as you can handle them.

You may have a catheter in your bladder to drain your urine for a day or so, or until you are able to get out of bed and move around. Report any painful urination or other urinary symptoms that occur after the catheter is removed. These may be signs of an infection that can be treated.

You may be moved to a rehab facility for a while to regain your strength. This depends on your status.

Before you are discharged from the hospital, arrangements will be made for a follow-up visit with your healthcare provider. They will also give you instructions for home care.

At home

Once you are home, it is important to keep the incision clean and dry. Your healthcare provider will give you specific bathing instructions.

You may choose to wear a loose turban or hat over the incision. Don’t wear a wig until the incision is completely healed (about 3 to 4 weeks after surgery).

The incision and your head may ache. This is especially true with deep breathing, coughing, and exertion. Take a pain reliever for soreness as advised by your healthcare provider. Aspirin or other blood-thinning medicines may increase the chance of bleeding. Be sure to take only advised medicines and ask if you are unsure.

Continue the breathing exercises used in the hospital to prevent lung infection. You will be advised to stay away from exposure to upper respiratory infections (colds and flu) and irritants. These include tobacco smoke, fumes, and environmental pollution.

Slowly increase your physical activity as tolerated. It may take a few weeks to return to your previous level of energy and strength.

You may be instructed to not lift heavy items for a few weeks to prevent strain on your surgical incision.

Don’t drive until your healthcare provider says it’s OK.

Get medical care right away if you have any of these symptoms:

• Fever or chills

• Redness, swelling, bleeding, or drainage from the incision site or face

• Increased pain around the incision site

• Vision changes

• Confusion or excessive sleepiness

• Weakness of your arms or legs

• Speech problems

• Trouble breathing, chest pain, anxiety, or change in mental status

• Green, yellow, or blood-tinged sputum (phlegm)

• Seizure activity

Your healthcare provider may give you other instructions about what to do after a craniotomy.