Procedure of the operation
The aim of the operation is to remove the bruise as completely as possible and eliminate the cause of the bleeding. To do this, the bony skull must first be opened (= craniotomy). The neurosurgeons choose the location of the craniotomy in such a way that the doctors can reach the bleeding by the shortest route without having to inflict major damage on other structures.
After opening the skull, the hard meninges (dura) must also be opened and the way to the bleeding cavity must be prepared, i.e. the doctors use their instruments to penetrate the brain tissue to the site of the bleeding. If the bruise is still quite fluid, it can easily be suctioned off with a cannula. Clotted blood (coagulum) must be removed with a so-called grasping forceps.
While rinsing and suctioning, one tries to empty the bleeding cave. This must be done very carefully so as not to damage the surrounding brain tissue mechanically. If an aneurysm is the cause of the bleeding, one tries to eliminate it by means of a so-called clip or coil to prevent further bleeding.
Once the procedure is finished, the skull is closed again and the skin incision is stapled. Would you like to learn more about brain aneurysm and its therapy? Then visit the page: Brain aneurysm – causes and therapy
What are the risks?
As a matter of principle, the benefits of the operation must be weighed up against the risks before every operation. Most operations after cerebral haemorrhages are emergency operations or operations without which a life-threatening condition will develop for the patient in the course of time. In principle, complications can occur in individual cases with all surgical interventions.
This is of course also the case with neurosurgical interventions. The most important general risks are secondary bleeding, infections, wound healing disorders and anaesthetic incidents. To operate on a cerebral hemorrhage, a hole must always be made in the bony skull first.
This can allow germs to get in and cause an infection. If the bleeding is not localized on the brain surface, further brain regions can be damaged by the surgical access route. This can trigger epileptic seizures or lead to paralysis and speech disorders.
The choice of the access route is therefore considered very carefully.A team of neurosurgeons also considers very carefully the question of whether an operation is necessary at all. Not every brain haemorrhage necessarily has to be operated. Older patients with pre-existing conditions also have an increased risk of anaesthesia.
This fact is also included in the decision. However, if you are planning to have a brain hemorrhage operation, a doctor in charge will normally inform you about the risks, procedure and possible alternatives before the operation. Would you like to learn more about postoperative risks in general? Then visit our page: Postoperative complications
