Craniotomy

Brain tumors, aneurysms, and other serious conditions in the brain often require immediate attention, including brain surgery. When you need a complex procedure like a craniotomy, you can trust the experts at WMCHealth.

Our cranial neurosurgeons have the experience and technology to support you through even the most challenging circumstances. Our surgical teams in New York are pioneers of advanced technologies and regularly perform brain surgery using minimally invasive techniques.

What is a Craniotomy?

A craniotomy is a surgical procedure that temporarily removes a section of the skull so a neurosurgeon can access the brain. This section, called a bone flap, is replaced and secured after treatment.

A craniotomy may be used to treat several conditions, including:

• Brain tumors
• Blood vessel abnormalities
• Infections
• Epilepsy

For brain tumors, surgery can help provide a diagnosis, relieve pressure, or remove as much tumor as possible. Your surgeon will explain the goals of your operation and whether additional treatment may be needed.

What to Know About Your Craniotomy

Your preparation, surgical approach, and recovery depend on your condition and the planned procedure.

How to Prepare for a Craniotomy

Our team reviews your diagnosis, imaging, and overall health before surgery. Specialized scans can help map out nearby areas involved in movement, language, vision, and other functions. Your surgical team will provide personalized instructions to help you prepare for your operation.

What to Expect During the Craniotomy

• You usually receive general anesthesia. You may be awake during portions of surgery for brain mapping and to test things like reflexes.
• The neurosurgeon makes an incision and temporarily removes a section of skull. The opening’s size and location depend on the condition being treated.
• The surgeon treats the affected area, using imaging, navigation, or mapping techniques when appropriate.
• After treatment, the bone flap is generally replaced and secured, and the incision is closed.

What to Expect After a Craniotomy

Your care team closely monitors you after surgery, sometimes initially in a neurological intensive care or step-down setting if needed. Imaging may be used to evaluate the results of surgery. Hospital stay and overall recovery vary with your procedure, health, and symptoms present before surgery.

• Fatigue and headache can occur during the early stages of recovery. Your team will explain expected symptoms and when it is appropriate to seek medical attention.
• You receive instructions about site care, medications, driving, exercise, and returning to work.
• Follow-up appointments and imaging help your team assess your recovery and plan any additional care as needed.

Advanced Techniques for Brain Tumor Surgery

WMCHealth offers a range of advanced technologies and techniques that may be used during a craniotomy when appropriate.

Brain Mapping and Awake Craniotomy

Brain mapping helps surgeons locate areas that control speech, movement, and other critical functions. Some patients remain awake during parts of surgery so the team can test these functions.

WMCHealth also uses AI-assisted mapping to show important connections within the brain. This information helps surgeons plan tumor removal and reduce the risk of injury.

Fluorescence-Guided Surgery

For certain brain tumors, a fluid called 5-ALA makes tumor tissue glow under a special light. This helps surgeons differentiate tumor tissue from nearby brain tissue, allowing the team to preserve as much healthy tissue as possible.

GammaTile Brachytherapy

GammaTile delivers targeted radiation through small tiles placed where a brain tumor was removed. The tiles gradually dissolve while radiation treats nearby tissue where tumor cells may remain. This approach limits radiation exposure to healthy brain tissue.

Laser Interstitial Thermal Therapy (LITT)

LITT uses a thin, MRI-guided laser probe to heat and destroy targeted brain tumor tissue. With this technique, you may be able to return home the next day, depending on your condition and recovery.

Risks of Craniotomy

As with any major operation, craniotomy has potential risks. These vary depending on the location and type of condition being treated. Craniotomy risks include:

• Bleeding or infection
• Seizures
• Leakage of cerebrospinal fluid, which surrounds the brain and spinal cord
• Blood clots or stroke
• Neurological changes, which may affect movement, speech, memory, or other functions

Your neurosurgeon will discuss the expected benefits and individual risks of your procedure. This discussion can help you understand your options and ask questions before surgery.

Why Choose WMCHealth for Craniotomy

Our team brings personalized planning, advanced surgical tools, and collaboration to your care.

Individualized Surgical Planning

Your surgeon evaluates your condition and its relationship to important brain structures. The recommended approach considers your treatment goals, neurological function, and quality of life.

Techniques That Support Neurological Function

Imaging, computer-assisted navigation, and brain mapping help guide planning and surgery. Certain tumor operations may also use fluorescence guidance to help distinguish tumor tissue.

Collaboration Across Specialties

Neurosurgeons work with specialists in imaging, pathology, neurocritical care, and other fields to meet your exact needs. For brain tumors, care may also involve neuro-oncology and radiation oncology.