Neuro 1 Cranial surgery

Preop prep for cranial surgery

INFORM the pt that they will have some hair removed, let know how much and where. Informed consent. Pt teaching about what will happen during and after. Inform that they will be in ICU regardless for close monitoring. Inform family about what to expect.

Types of cranial surgeries

Burr hole, craniotomy, craniectomy, cranioplasty, stereotactic procedures, shunt procedures.

Craniectomy surgery

Excision made into cranium to cut away bone flap to provide space for expansion.

Side effects of radioprocedures on brain

Fatigue almost always, HA. and nausea especially if nausea center is affected.

Monitor in pt post op

Frequent vital signs, pain level, nausea (with meds to prevent vomiting WITHOUT sedation)

Positioning of pt post op

HOB up 30 degrees, turn q2, do not put craniectomy pt on operative side ( for obvious reasons)

Assessment of pt post op

Neuro checks, fluid and electrolyte levels, serum osmolality monitoring for SIADH, diabetes insipitus (leading to hypovolemia)

Post op care of cranial surg pt

Primary goal is to prevent IICP through close assessments, monitoring, positioning, and incision care.

Also super important post op

ROM, hand hygiene, infection precautions, possible seizure precautions, vigilant monitoring!

Cranioplasty

Repair of a cranial defect using some type of artificial material to replace damaged or lost bone.

Craniotomy surgery

Set of burr holes drilled then a craniotome(saw) is used to connect the holes to remove a bone flap.

Burr hole surgeries

Simplest, opening drilled through skull to remove fluid and or blood beneath dura or prep for craniotomy. Can be used in emergency situation to relieve some pressure temp.

Shunt procedures in brain surgery

To drain CSF from brain to help with IICP

Stereotactic procedures

Uses CT/MRI and computer imaging for a 3D image of the target area. A needle or probe is inserted to remove small tumors,lesions, abscesses, perform ablations, or to drain hematomas. OR for use during radio procedures to provide large doses of gamma radiation to a target area. OR laser used on a very pinpoint specific area decreasing damage to surrounding areas.