When does one need surgery?
In principle, not all patients with an existing cerebral hemorrhage benefit from surgical therapy. Therefore, it is important to carefully consider in each case whether or not surgery is indicated for this patient. In most cases, a bleeding is only considered worthy of surgery if it leads to a neurological disorder.
This assumes that so much blood has flowed into the skull that certain areas of the brain are now pushed away and can no longer perform their actual function. This is called a symptomatic cerebral hemorrhage. In addition, one must differentiate between the exact location of the bleeding, since the blood can only be removed surgically if the cause of bleeding is as superficial as possible or directly in the cerebellum.
It is difficult to describe an exact time frame for the operation of a cerebral hemorrhage, since it depends on various factors. These include the location of the bleeding and the extent of the bleeding, as well as other circumstances such as the experience of the surgeon or any complications. As a rule, however, one can speak of a general duration between two and eight hours.
In individual cases, however, the duration of the operation can vary considerably from this figure. Since the surgical treatment of a cerebral hemorrhage is almost always accompanied by the opening of the skull bone, such an operation is naturally associated with certain risks. On the one hand, brain surgery always involves the possibility that certain regions of the brain may be damaged during the operation, possibly resulting in functional deficits.
However, such a complication is comparatively very rare. Furthermore, it is possible that patients have an epileptic seizure during the operation, but this can be treated well and quickly. There is also the risk of post-operative bleeding if not all vessels are adequately treated or injured during the operation.
In almost all cases, the operative therapy of a cerebral hemorrhage is accompanied by the opening of the skull, the so-called craniotomy. For this purpose, the hair is first shaved away in the operating area. Then, under general anesthesia, the skin in this area is carefully removed from the skull bone and folded aside.
Now the actual opening of the skull takes place, in which the skull bone is opened with an appropriate saw. This is followed by the removal of the blood and the supply of the injured vessel. As soon as the surgeon is sure that all vessels are well supplied, the skull is closed again.
The sawn out bone plate is anchored to the rest of the skull either with plates or wires and the skin is sutured. In most cases, after the hair has grown back, there is nothing to be seen of the operation.
