Cranial Surgery Indications and Types

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Questions and Answers

What is the primary purpose of a craniotomy?

To create an alternative pathway for cerebrospinal fluid

To precisely target a specific area of the brain without cutting away bone

To remove a lesion, repair damaged areas, drain blood, or relieve increased intracranial pressure (correct)

To repair a cranial defect using artificial material

Which surgical procedure is typically performed to remove localized fluid and blood beneath the dura?

Craniectomy

Burr hole (correct)

Cranioplasty

Stereotactic biopsy

What is one major advantage of stereotactic procedures in cranial surgery?

They always provide quicker recovery times

They reduce damage to surrounding tissue (correct)

They require no anesthesia

They eliminate the need for imaging technologies

In which cranial surgery is a bone flap cut away?

Craniotomy Signup and view all the answers

What is the main reason patients would receive care in the ICU after cranial surgery?

To monitor for stabilization after surgery Signup and view all the answers

During which procedure might a biopsy needle be introduced to obtain tissue samples?

Stereotactic biopsy Signup and view all the answers

What type of cranial surgery involves repairing a defect using artificial material?

Cranioplasty Signup and view all the answers

What is the purpose of shunt procedures in cranial surgery?

To redirect cerebrospinal fluid using a tube or device Signup and view all the answers

What is the primary purpose of stereotactic radiosurgery?

To destroy precisely targeted tumor cells Signup and view all the answers

What type of imaging is utilized during stereotactic radiosurgery?

3-dimensional images Signup and view all the answers

What is a common side effect of stereotactic radiosurgery?

Nausea Signup and view all the answers

What is a critical goal of nursing care after cranial surgery?

Preventing increased intracranial pressure Signup and view all the answers

Which medication should not be administered postoperatively to avoid increased somnolence?

Promethazine Signup and view all the answers

What should be monitored closely during the first 48 hours after cranial surgery?

Neurologic status Signup and view all the answers

What type of therapy reduces damage to surrounding tissue during tumor destruction?

Laser therapy Signup and view all the answers

If a bone flap is removed during a craniectomy, what should be avoided in terms of patient positioning?

Positioning on the operative side Signup and view all the answers

What should the nurse do if they observe excess bleeding or clear drainage at the surgical site?

Immediately notify the healthcare provider Signup and view all the answers

Cognitive and emotional residual deficits after cranial surgery are often considered to be:

Harder to accept than motor and sensory losses Signup and view all the answers

What approach is typically taken in nursing care for a patient after cranial surgery?

Collaborative care based on individual needs Signup and view all the answers

During preoperative teaching, which aspect should be communicated to the patient about hair removal?

Hair is usually removed before induction of anesthesia Signup and view all the answers

What role do social workers play in the care of patients after cranial surgery?

They assist with adapting to changes in home life and financial circumstances Signup and view all the answers

Study Notes

Indications for Cranial Surgery

Related to conditions: brain tumors, CNS infections (e.g., abscess), vascular abnormalities, craniocerebral trauma, seizure disorders, intractable pain.

Types of Cranial Surgery

Craniotomy: Involves opening the cranium to remove a lesion, repair damage, drain blood, or relieve increased intracranial pressure (ICP).
- Bone flap removed and secured post-surgery with plates or wires.
Stereotactic Radiosurgery: Uses high-dose radiation, not traditional surgery.
- Precise targeting using 3D images, typically for small tumors and abnormal growths.
- Administered through radiation sources like linear accelerators, Gamma Knife, or CyberKnife.
Burr Hole: Created with a drill to remove localized fluid and blood beneath the dura.
Craniectomy: Surgical excision to remove a bone flap.
Cranioplasty: Repair of skull defects using synthetic materials post-trauma or surgery.
Shunt Procedures: Redirect cerebrospinal fluid using a tube or device, such as a ventricular shunt or Ommaya reservoir.
Stereotactic Procedures: Allow for precise localization of brain areas for biopsy or radiosurgery.

Nursing Management: Acute Care

General care similar to patients with increased ICP.
Importance of preoperative teaching to ease patient and family anxiety regarding prognosis and outcomes.
Post-operative monitoring focused on preventing increased ICP:
- Frequent neurologic assessments for the first 48 hours.
- Monitor fluid/electrolyte levels; detect diabetes insipidus or hypovolemia.
- Pain management with short-acting opioids; nausea control with antiemetics (avoid promethazine).

Postoperative Positioning and Care

Elevate head of the bed 30 degrees for anterior/middle fossa surgeries.
Keep patient flat or slightly elevated (10-15 degrees) for posterior fossa or burr hole surgeries.
If craniectomy was performed, avoid positioning on the operative side.
Meticulous scalp care and monitoring of dressing and drains for signs of infection or excess drainage.

Psychosocial Considerations

Address the emotional impact of hair removal; suggest alternatives like wigs or scarves.
For radiation patients, recommend sunblock and head covering for sun exposure.

Ambulatory Care and Rehabilitation

Rehabilitation decisions based on surgery type, recovery, and overall health.
Encourage independence through tailored care plans focusing on functional capabilities.
Collaborate with therapists for functional, communication, and swallowing rehabilitation.
Address cognitive and emotional impacts of the surgery; support from social workers may be beneficial for family adaptation.

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Description

This quiz covers the indications for cranial surgery related to various conditions such as brain tumors, CNS infections, and vascular abnormalities. It also outlines different types of cranial surgeries, including craniotomies and their specific approaches. Test your knowledge on this critical area of neurosurgery.