Procedures in TIBSS Hospital

Craniotomy and Craniectomy

The Craniotomy is a surgical operation in which 
a portion of bone is temporarily removed from the skull to allow access to the brain so that the disease can be tackled surgically. Craniotomies are undertaken for brain tumours, injuries, aneurysm, arteriovenous malformations or other surgically amenable lesions. These operations are often fraught with serious complications but modern neurosurgeons are equipped with skill and resources to circumvent these complications. The craniotomy is differentiated from Craniotomy in which the removed portion of the skull is not immediately replaced and scalp is sutured without the underlying bone. This procedure provides space to accommodate brain swelling which may otherwise create life-threatening raised pressure inside the skull.

Surgery for Head Injuries

Traumatic Brain Injury (TBI) occurs when the head gets injured in an accident due to a fall or an assault. The timely operation may be required to save the life or to limit disability by surgically removing blood clots or by performing Craniotomy (see above) to allow the injured brain to swell without raising potentially lethal pressure inside the skull.

Surgery for stroke

There are two main types of stroke, ischemic stroke, and hemorrhagic stroke.

An ischemic stroke occurs when a blood clot prevents blood from flowing to the brain and results in death (infarction) of the affected portion of the brain. If treatment is made available within three hours for this type of stroke, it may be possible in some cases to administer a medication to dissolve the clot. In some other cases, procedures are carried out to physically remove the offending clot through tiny blood vessels of the brain. Sometimes the infracted brain can rapidly swell and cause a dangerous rise in pressure inside the skull. In these cases, a decompressive, craniotomy may be required urgently as a lifesaving procedure.

A hemorrhagic stroke occurs as a result of rupture of a blood vessel in the brain and blood collects into the surrounding brain and adjacent spaces. Hemorrhagic strokes can occur in three situations. Firstly very high blood pressure can cause progressive damage to the small blood vessels in the brain and result in bleeding into the brain tissue. Secondly, an aneurysm, which is an abnormal ballooned out portion of a blood vessel, can rupture and bleed. Thirdly an arteriovenous malformation, which is a bunch of abnormally formed blood vessels, can cause bleeding. Hemorrhagic stroke treatments involve supportive treatment to maintain blood pressure and other vital functions, measures to stop further bleeding in the brain and reduce the ill effects associated with brain bleeding. Surgical procedures include surgical clipping or coiling of the ruptured aneurysm. Surgical Excision, Embolization or Gamma Knife therapy is carried out for arteriovenous malformations. Some large clots which are located superficially may require surgical evacuation.