There are various conditions affecting the brain. Trauma due to head injury, cerebral aneurysms and AVMs or ArterioVenous Malformations, brain tumors, neuropathic facial pain, epilepsy, and infection in the head or brain are some of the conditions that would require neurosurgeons to diagnose and treat.
Brain surgery or neurosurgery is that field of medicine focused in diagnosing and treating conditions of the peripheral, central and autonomic nervous system. Neurosurgery has undergone some major advancements over the past 2 decades or so. The fact that neurosurgeons are able to operate on parts of the brain which seemed impossible many years ago, just indicate how much the field of neurosurgery has evolved. In terms of instruments, gadgets or medical equipment, neurosurgery continues to top the other surgical procedures as patients who have not been cleared for surgery in the past due to their physical and health conditions have been given the chance to correct their problem through non-invasive surgical ways.
A craniotomy is a surgical procedure performed by a neurosurgeon that involves removing a bone flap or a piece of the skill in order to allow the neurosurgeon to gain access to the brain. After the procedure, the bone flap is placed back to its original position to allow healing and mending like any other broken bone. The steps or procedures that would follow after the bone is removed will depend largely on what condition is being treated.
A craniotomy is performed for a number of reasons and conditions. Brain tumor, trauma caused by head injury, arteriovenous malformations or AVMs, cerebral aneurysms, pain or neuropathic facial cream, epilepsy, infection in the head such as cerebral abscess, intracranial empyema and osteomyelitis all require craniotomy as part of the treatment option.
Types of Craniotomy
There are different ways a craniotomy is done and it depends on the type of surgery that follows it. The different types of craniotomies included endoscopic craniotomy, craniectomy, stereotactic craniotomy, eyebrow craniotomy, keyhole craniotomy, translabyrinthine craniotomy and awake craniotomy.
Brain surgery clinics across the country in different states like New Orleans offer endoscopic craniotomy hoping to help many people with some real serious brain or head problems. Endoscopic craniotomy is considered a minimally invasive brain surgical procedure which involves inserting a lighted scope attached with a camera into the brain through a small cut in the skull. This procedure does not require removing an entire bone flap. Only small keyhole incisions in the skull are done by the neurosurgeons in New Orleans.
This surgical procedure is similar to a craniotomy where a bone flap is removed but unlike craniotomy, the bone flap is not returned to its original location after the procedure. This may be caused by trauma to the bone which causes brain swelling that prevents the return of the bone flap. The neurosurgeon may decide not to return the bone flap if it is in the patient’s best interest, such as if there is infection in the brain area in which case discarding the bone flap may be discarded.
Most of the craniotomy procedures are performed using the assistance of computerized navigation techniques, or computers and imaging called intraoperative monitoring in order to reach the location within the brain for treatment as precisely as possible. This technique uses a frame placed onto the skull, or a frameless system using lightly-placed markers on the scalp. Any of these two imaging procedures used along with craniotomy is referred to as stereotactic craniotomy. Brain scans done in connection with such computers and localizing frames, will provide a 3-dimensional image of a brain tumor. This is useful in distinguishing tumor-affected tissue from healthy tissue.
This surgical procedure is also known as supra-orbital craniotomy used to remove brain tumors. Neurosurgeons access the tumors in the front of the brain or around pituitary gland by making a small incision within the eyebrow. This procedure is used when a tumor is very large or close to the vital arteries or the optic nerves. Endonasal endoscopic surgery used to be performed for such situations.
This minimally-invasive surgical procedure is also known as retro-sigmoid craniotomy performed for brain tumor removal. Skull base tumors may be removed using this procedure through a small incision behind the ear, where access to the cerebellum and brainstem is provided. This procedure will allow neurosurgeons to reach certain tumors, such as meningiomas and vestibular schawnnomas or acoustic neuromas.
This is another minimally-invasive surgical procedure that involves making an incision in the scalp behind the ear where the mastoid bone and portions of the inner ear bone are found. The neurosurgeon then locates and aims to remove the tumor or almost all of it without the risking or causing severe brain damage.
This surgical procedure, patients are sedated while the neurosurgeon opens the skull to expose the brain. Anesthetic doctors and neurosurgeons will then bring the patient to full consciousness and out of sedation. The patient may interact with the neurosurgeon during the procedure. This will help neurosurgeons in making sure that healthy tissues are not damaged as the brain tumor or much of it is removed. Neurosurgeons will throw in some questions to the patient. Patients will be asked to do ordinary and simple tasks to make sure that his speech and motor functions are not affected in any way.
Awake craniotomy is usually performed in the intraoperative MRI suite to allow neurosurgeons to make real-time MRI images during the procedure which will show if the brain tumor is removed. Awake craniotomy is a better option for patients with brain tumors in areas near speech or motor centers in the brain. Neurosurgeons expect better results from the procedure allowing more functions to be preserved than any other form of treatment.
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