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Trepanation of the skull is a difficult and complicated operation that involves opening the skull by drilling tiny holes in it. This neurosurgical procedure is used for both therapeutic and diagnostic purposes. What are the indications for trepanation of the skull? What does the procedure look like and are there any possible side effects afterwards?
What is skull trepanation?
The skull is a bone structure whose main task is to protect the brain from external factors. The cranial cavity is limited by tight connections between the bones, which keep the volume unchanged. Inside the cranial cavity, there are three basic elements, namely the nerve tissue that makes up the brain, the cerebrospinal fluid, and the blood flowing through the vessels. When there is an increase in the volume of one of these elements, the other two are compressed, which can lead to serious consequences. To restore balance in the cranial cavity, a cranial trepanation procedure is performed, which allows the hematoma to be decompressed quickly. Trepanation of the skull is an operation with a long history. This type of procedure was performed as early as around 1400 BC. At that time, however, the procedure was associated with high patient mortality. On average, every third operated patient died during or after the operation. Skull trepanation, despite its complexity, is a less invasive procedure than, for example, a craniectomy, during which part of the skull bone is removed.
Skull trepanation – indications
Skull trepanation is performed in the operating room in cases that require immediate surgical intervention. The indications for trepanation of the skull are:
- injuries after an accident, if there is an intracranial hematoma or if there is a fracture or fracture of the skull;
- monitoring of intracranial pressure, especially in the case of hydrocephalus or cerebral edema;
- stereotaxic biopsy;
- insertion of the drain into the ventricular system of the brain
- some surgical procedures that insert electrodes into specific parts of the brain;
- reconnaissance trepanation.
Skull trepanation – the course of the operation
Cranial trepanation is a neurosurgical procedure in which one or more holes are drilled into the skull. The operation is performed under general anesthesia. Initially, the patient’s hair is cut and shaved where the trepanation holes will be drilled. The choice of the place where the holes will be drilled depends on the purpose for which the procedure is performed. Holes are made using a manual or electric trepane. The further course of the operation depends on whether the trepanation was caused by a cerebral hematoma, hydrocephalus or cerebral edema. The last element of the skull trepanation procedure is closing the drillings with bone wax. The scalp, on the other hand, is sewn up.
Skull trepanation – convalescence
The recovery period after trepanation of the skull depends on the cause of the procedure. For example, an intracranial hematoma is a serious ailment and after the procedure you should lead a very relaxed lifestyle for at least a few weeks, devote a lot of time to sleep and rest. It should be remembered that alcohol should be completely discontinued after trepanation.
Possible complications after trepanation of the skull
Trepanation of the skull, as well as any other operation, may cause some complications. The most common ones include:
- swelling of the brain;
- cerebral hypoxia;
- meningitis;
- intracerebral hematoma formation;
- formation of a subdural empyema;
- postoperative wound infections.
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