A craniotomy means lifting a small piece of bone from the skull, working on the brain or the skull base underneath, and then putting the bone back. It is the time-tested route for tumours and vessel problems that are too large, too hard or too spread out to be reached with an endoscope.
Who it may help
- A large or firm tumour at the base of the skull
- A tumour that sits close to important nerves or blood vessels
- A tumour that has returned after earlier surgery or radiotherapy
- An aneurysm or vessel malformation that cannot be treated from inside the vessel
- A skull-base injury that needs repair
Conditions treated
- Skull-base meningiomas
- Vestibular schwannomas (acoustic neuromas)
- Residual or recurrent tumours
- Tumours of the brainstem region and the back of the skull base
- Large pituitary tumours that spread upwards or sideways
- Aneurysms and vascular malformations at the skull base
- Fractures involving the skull base
Approaches used
- Pterional A route from the side of the forehead, used for many aneurysms and front-of-brain tumours.
- Suboccipital and retrosigmoid Routes behind the ear and at the back of the head, used for tumours near the cerebellum and the hearing and balance nerves.
- Orbitozygomatic A wider window that includes part of the eye socket bone, used for deep tumours that need more room.
- Tailored to you The route, the size of the opening and the head position are planned on your own scans.
Before the procedure
- MRI, CT and sometimes an angiogram
- Blood tests and anaesthesia check
- A full discussion of the benefits, risks and alternatives
- Planning with the anaesthesia and intensive-care teams
Recovery: what to expect
- Most people spend a day or two in intensive care for close observation.
- A hospital stay of roughly 5 to 7 days is usual.
- Headache and swelling around the incision are common for the first few days.
- Stitches or staples come out at about 7 to 10 days.
- Return to work is often around 4 to 6 weeks, depending on the operation and the job.
- Scans are repeated at about 1, 3 and 6 months.
These are typical timings. Your own plan depends on your condition, your general health and the operation chosen, and Dr. Chakraborty will go through it with you.
Risks to know about
Every operation carries risk. The ones most relevant here are:
- Bleeding, infection or swelling of the brain
- Weakness, numbness or speech difficulty, depending on where the tumour sits
- Hearing, balance or facial nerve problems with some skull-base tumours
- Seizures, which can usually be prevented with medicines
- Leakage of brain fluid
Your own risks depend on your health and your scans, and are explained in detail before you decide on anything.
Common questions
Will all my hair be shaved?
Only a small area along the incision is usually shaved, and it is covered by hair once it grows back.
Is open surgery more dangerous than endoscopic surgery?
It carries different risks. For large or complex tumours it is often the safer and more complete option. Your surgeon will explain why one route is chosen over the other.
How long is recovery?
Most people feel much better within 4 to 6 weeks, although full recovery can take longer after a big operation.
Will I need rehabilitation?
If the tumour or the surgery has affected strength, speech or balance, physiotherapy and speech therapy are arranged.
This page is general information to help you prepare for a consultation. It is not medical advice and does not replace an examination. Every plan is made for the individual patient.