Craniotomy, or trepanation of the skull, is a surgical procedure to create an opening in the bony tissue of the skull. This access is typically performed to get as close as possible to intracranial formations, such as tumors.
Types of Craniotomies:
- Burr hole
- Traditional trepanation of the skull
- Stereotaxy – indicated for visualizing brain structures that need to be operated on using computer assistance
- Awake craniotomy – performed under local anesthesia; indicated for tumors located in functionally significant areas of the brain responsible for speech and movement.
Indications
Craniotomy is performed for the surgical treatment of various neurological diseases, tumors, injuries, and vascular pathologies. Other indications for the surgery include: removal of foreign bodies (e.g., bullets), brain edema, and infections.
Craniotomy is most often performed for:
- Decompression of the brain;
- Surgical treatment of vascular pathology of the brain;
- Removal of hematomas;
- Removal of brain tumors.
Diagnosis for Craniotomy in Israel
Before the surgery, each patient undergoes a series of diagnostic procedures to determine any contraindications for the operation:
- ECG – for patients over 40 years old
- Chest X-ray – for all patients over 60 years old, as well as smokers, those with chronic lung diseases and upper respiratory tract conditions, obesity, and diabetes
- CT scan of the brain
- Angiography to visualize the blood vessels of the brain
- CT angiography – advantages over conventional angiography include reduced radiation exposure to the patient and a lower risk of complications from surgical manipulations required in conventional angiography
- Functional and standard magnetic resonance imaging
- Positron emission tomography.
Additionally, prior to performing a craniotomy, a series of neurological tests are required:
- Assessment of pain and temperature sensitivity
- Determination of tendon reflex activity
- Finger-nose test
- Romberg test for stability.
Craniotomy Treatment in Israel
All types of trepanation at the Ichilov clinic in Israel are performed exclusively using the latest equipment and instruments for trepanation: pneumatic and electric trephines. Thanks to such devices, Israeli doctors extract a section of the skull bone without damaging it, and after the operation, use it for autoplasty.
Craniotomy at the Ichilov clinic in Israel is performed under local or general anesthesia. Before the surgical intervention, sedative medications are administered to the patient. The head of the patient is then placed in a special holder and secured. This is done to prevent any movement or displacement of the head during the procedure.
Once the patient is prepared, the surgeon applies antiseptic to the previously shaved area of the head, then incises the skin and exposes the skull bone. After that, a fragment of the skull bone is removed using a special high-speed drill. Once the surgeon at the Ichilov clinic in Israel exposes the area for surgery from the dura mater, all further actions are performed under a special microscope. If the neurosurgeon discovers a tumor, it is removed using an aspirator, electric forceps, or an ultrasonic aspirator.
Upon completion of the craniotomy, the surgeon sutures the dura mater and, using autoplasty, returns the section of skull bone to its place. The incision in the skin is then closed.
The operation lasts on average 3-4 hours. The stay at the Ichilov clinic in Israel will last 3-6 days after the surgical intervention. The first 24 hours, the patient spends in intensive care. After discharge, physical activities should be avoided, and driving should be refrained from for at least 6-8 weeks.