Recovery and Rehabilitation after Craniotomy: What to Expect

A craniotomy is a procedure offered by neurosurgeons to gain access to the brain and involves the removal and subsequent replacement of a portion of the skull. The skull is typically reconstructed with small titanium fasteners that are designed to be secure and cosmetic. In other circumstances, the surgeon may elect to perform a similar procedure called a ‘craniectomy,’ whereby the bone is not replaced and the skull is reconstructed with synthetic materials that are FDA-approved for this purpose. Titanium mesh, calcium-based cements, or plastics are the materials most frequently employed—and this procedure is termed a ‘cranioplasty’. Craniotomy is implemented to allow for brain tumor resection, blood clot removal, drainage of infectious collections (abscesses), removal of unhealthy brain tissue causing seizures (epilepsy), securing vascular malformations and a myriad of other purposes.   

How is a craniotomy performed?

The procedure is most often performed under general anesthesia and involves making an incision in the scalp, typically behind the hairline—although eyebrow incisions are often considered to allow for more direct access to structures in the undersurface of the brain. The portion of skull that is  removed is called the ‘bone flap,’ and unless there is an active infection or tumor infiltration, it is reimplanted and secured with titanium or a synthetic absorbable material. As a result of the generous blood supply to the scalp, these wounds often heal well, and surgical scars are often difficult to discern when covered by hair.

What happens after a craniotomy?

 Post operatively, patients are typically managed in a neuro-intensive care unit for 24 hours or more, depending on the underlying reason for the surgery as well as the patient’s neurological status. For example, a patient who was treated with a craniotomy for management of a bleeding aneurysm will likely require a longer ICU stay when compared to a patient who required a similar surgery to remove a benign brain tumor. Often, additional imaging studies or diagnostic tests will be required to assess for complications, including Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), or electroencephalography (EEG)  Here, your neurosurgeon and the intensive care unit team team will monitor your progress until you’re able to be transferred to a surgical-step down unit. Upon transfer, you will be encouraged to engage in physical, occupational, and speech therapy depending on the presence or absence of disability. The duration of hospitalization after a craniotomy depends on the presence or absence of neurological disability, the reason surgery was performed, and the patient’s overall health prior to surgery.

During your hospitalization, the surgeon will determine when you may eat, when you may be mobilized from bed, and which medications are advisable. Your surgeon will also set blood pressure parameters among other nuanced aspects of care.  Your surgeon may request consultation from physicians with other specialty interests to help manage your case, and there is an emphasis on a collaborative team approach to care delivered in the hospital.

What is the Brain Surgery Recovery Process Like?

While each patient is unique, the average recovery time for a craniotomy is approximately six to eight weeks with most recovery being realized in the first week. At the time of discharge, you can expect clear instructions that outline the prescription of new medications, the timing of bathing, the nature of physical activity that is allowed, and when to return for a follow up appointment. You will also be given an estimate of when it is advisable to return to normal activities, including work and/or school. 

What is Craniotomy Rehabilitation? 

At times, patients may have trouble with walking, talking, and balance after a craniotomy. Your physician may prescribe physical, occupational, or speech therapy to help you regain normal function. While risk of neurological complications is a real consideration, recovering to a full and healthy life is the great probability after craniotomy, and many patients make a full recovery with minimal side effects or complications.

Craniotomies in New Jersey – Initial Diagnosis and Second Opinion Services 

For patients facing a brain tumor diagnosis, it is important to speak with a physician who is experienced in the management of brain tumors and has a specialty interest in neuro-oncology and skull-base surgery. For more than 25 years, the highly-skilled team at New Jersey Brain and Spine has helped more than 40,000 patients with complex brain and neurological conditions.

It has been our mission to offer personalized care to help patients and their families navigate the complexities of neurological of illness; we pride ourselves on our ability to communicate clearly and with empathy from the time of diagnosis through the moment that full recovery has been realized. To schedule an appointment, contact us today at 201-342-2550, option 3.