Craniotomy for Hematoma
What is Craniotomy for Hematoma ?
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Why do you need Craniotomy for Hematoma ?
Craniotomy for hematoma is indicated for:
- Epidural hematoma (EDH): Blood between the skull and dura, often from trauma (e.g., skull fracture lacerating an artery, typically middle meningeal).
- Subdural hematoma (SDH): Blood between the dura and brain, acute (trauma-related) or chronic (common in elderly, often from minor head injury).
- Intracerebral hematoma (ICH): Bleeding within the brain tissue, often due to hypertension, trauma, or aneurysm rupture.
- Symptomatic hematomas: Causing increased intracranial pressure (ICP), leading to symptoms like severe headache, confusion, seizures, weakness, or coma.
- Large hematomas: Significant mass effect on imaging (e.g., midline shift >5 mm, volume >30 mL for ICH), risking herniation.
The procedure aims to evacuate the hematoma, relieve pressure on the brain, control bleeding, and prevent further neurological damage.
Why Do Craniotomy for Hematoma Costs Vary in Philippines?
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Craniotomy for Hematoma Procedure
- Before Surgery Evaluation:
- Diagnosis:
- CT scan identifies the hematoma’s location, size, and mass effect (e.g., midline shift, compression of ventricles).
- Symptoms: Rapid deterioration (EDH), gradual onset (chronic SDH), or focal deficits (ICH).
- Blood tests: Coagulation profile (e.g., INR) to identify bleeding risk; correct coagulopathy (e.g., with vitamin K, fresh frozen plasma).
- Glasgow Coma Scale (GCS): Assesses consciousness (GCS <8 often indicates urgent surgery).
- Stabilization: Mannitol or hypertonic saline to reduce ICP; antiseizure medications (e.g., levetiracetam) if seizures occur.
- Consent: Risks, including bleeding or neurological deficits, are explained.
- Diagnosis:
- Surgical Techniques:
- Standard Craniotomy:
- Performed under general anesthesia, lasting 2–4 hours.
- The scalp is shaved and incised over the hematoma (e.g., 5–10 cm incision, often curvilinear).
- A bone flap (e.g., 5×5 cm) is removed using a craniotome.
- The dura is opened to expose the hematoma.
- Hematoma Evacuation:
- EDH: Clotted blood is removed; the bleeding artery (e.g., middle meningeal) is cauterized or ligated.
- SDH: Acute clots are suctioned; chronic SDH may involve irrigation to remove liquefied blood.
- ICH: Blood is carefully evacuated, avoiding damage to surrounding brain tissue; bleeding vessels are controlled.
- Hemostasis is achieved with bipolar cautery or hemostatic agents (e.g., Surgicel).
- A drain may be placed to prevent reaccumulation.
- The dura is closed; the bone flap is typically replaced with titanium plates/screws, and the scalp is sutured.
- Decompressive Craniectomy (Alternative):
- If significant brain swelling exists, the bone flap may not be replaced immediately to allow the brain to expand, reducing ICP. The flap is stored (e.g., in the abdomen) and replaced later (weeks/months).
- Intraoperative Tools:
- Neuronavigation: Guides precise access to deep hematomas (e.g., ICH).
- Ultrasound: Confirms hematoma removal.
- ICP monitoring: A probe may be placed to monitor pressure post-surgery.
- Standard Craniotomy:
- After Surgery:
- ICU monitoring for 1–3 days to watch for rebleeding, swelling, or seizures.
- Hospital stay: 5–10 days; longer if complications or decompressive craniectomy.
- Pain management: IV analgesics (e.g., morphine) for 1–2 days, then oral (e.g., ibuprofen).
- Antiseizure medications continue for 1–3 months; blood pressure control (e.g., labetalol) for ICH.
- Follow-up CT at 24–48 hours to confirm hematoma resolution and check for rebleeding.
Recovery After Craniotomy for Hematoma
- Hospital Stay: 5–10 days; longer (2–4 weeks) if decompressive craniectomy or complications.
- Post-Surgery Care:
- Pain: Scalp discomfort for 1–2 weeks, managed with analgesics.
- Activity: Light walking on day 2–3; avoid heavy lifting for 6–8 weeks.
- Neurological monitoring: For improvement in deficits (e.g., weakness, speech issues); recovery varies by hematoma type and severity.
- Rehabilitation: Physical, occupational, or speech therapy if deficits persist (common in ICH).
- Helmet: Required if decompressive craniectomy (bone flap not replaced) until cranioplasty (bone flap replacement, 6–12 weeks later).
- Diet: Normal diet; high-protein foods (e.g., eggs, lentils) support healing; 2–3 liters water daily.
- Follow-Up:
- CT at 1–2 weeks to monitor for rebleeding or swelling.
- Visits at 2 weeks, 6 weeks, and 3 months; neurological assessment for recovery.
Recovery varies: EDH with timely surgery often has good outcomes (70–90% full recovery); acute SDH (40–60% recovery, higher mortality in elderly); ICH outcomes depend on size/location (30–50% significant disability). Most resume normal activities in 6–12 weeks.
Risks and Complications
- Surgical Risks: Rebleeding (3–5%), infection (2–5%, e.g., meningitis), brain swelling (5–10%).
- Neurological Complications:
- Deficits (10–20%): Weakness, speech/vision loss, depending on hematoma location.
- Seizures (5–10%), managed with medications.
- Hydrocephalus (5–10%): May require a shunt.
- General Risks: Anesthesia reactions, blood clots (DVT, 2–5%).
- Long-Term: Cognitive decline (esp. ICH, 20–30%), persistent deficits, need for cranioplasty (decompressive craniectomy).
Report fever, severe headache, or neurological changes promptly.
Frequently Asked Questions (FAQs)
What causes a brain hematoma?
Trauma (EDH, SDH), hypertension (ICH), aneurysm rupture, anticoagulation therapy, or underlying vascular malformation.
Can a hematoma be treated without surgery?
Small, asymptomatic hematomas may be monitored; surgery is needed for large hematomas, mass effect, or neurological decline.
Will I regain full function?
Depends on hematoma type and timing: EDH (70–90% recovery with prompt surgery); SDH/ICH (higher risk of deficits, esp. if delayed).
How soon can I resume activities?
Light activities in 2–3 weeks, normal routines in 6–12 weeks.
Is craniotomy for hematoma covered by insurance in India?
Yes, for trauma or symptomatic hematomas; confirm with your provider.
Signs of complications?
Fever, severe headache, seizures, or new neurological deficits.
Can a hematoma recur?
Yes, 5–15% risk, esp. chronic SDH or if underlying cause (e.g., anticoagulation) isn’t managed.
Lifestyle changes post-surgery?
Avoid heavy lifting for 6–8 weeks, control blood pressure, adhere to medications, attend rehabilitation, and follow up regularly.
Conclusion
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Looking for Best Hospitals for Craniotomy for Hematoma
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.