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Brain Craniotomy

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Sunmade A.
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  1. The Rationale Behind Awake Craniotomy
  2. Utility of Awake Craniotomy
  3. Anesthesia
  4. New Anesthetic Agents
  5. Desflurane
  6. Sevoflurane
  7. Remifentanil
  8. Monitoring
  9. New Procedures
    1. Stereotactic Biopsy/ Craniotomy
  10. Kinds of Anesthetics
  11. Anesthetic Techniques
    1. Local Anesthesia
    2. Intravenous Agents
  12. The general procedure for craniotomy includes...
  13. Steroid Medication
  14. Anticonvulsant Therapy

Undoubtedly, the brain is an essential organ of the human body. Without this vital organ, senses such sight, hearing, tasting, smelling and feeling cannot be put to use. The brain controls everything in the human body 1 and is considered a complex structure. It is a mass of nervous tissue assembled together, weighing three pounds with more than ten billion cells present in it. The brain is able to receive impulses from various structures of the body. The brain is given the function of examining the received impulses and making the necessary adjustments or movements for that particular event. The brain is termed as man's consciousness, memory, reasoning and intelligence. The idea that emotions are controlled by the heart is a misnomer. The emotions felt by humans are still controlled by the brain 2.
The human brain is synonymous to an electrical company wherein million of wires are needed to make the transfer of impulses smoothly and if one wire is not functioning accordingly, it will have an effect on the whole system. Similar with the brain, millions of nerves are present and function properly to guarantee smooth transmission of impulses. If a part of the brain has been affected or if a nerve was damaged along the process, it can affect the proper functioning of the brain.

[...] Despite the mapping of the functions of the human brain and its parts, understanding the whole process occurring inside the brain is still limited. There is no specific procedure that can keep track of the neural connections from the brain to its parts resulting to restricted surgical procedures. Diffusion-weighted MRI has been evaluated as regards its utility to track down the neural connections within the brain19. Different techniques have been tested to know what would be the most effective in mapping the brain and its functions. [...]


[...] Intraoperative use during craniotomy is cumbersome and unsubstantiated as a modifier of outcome. There is increasing hope that computerized analysis of TCD waveforms may provide useful data on intracranial pressure (ICP) and this could be useful during induction. Clearly, TCD can recognize entire barriers to blood flow. Still, there are more helpful information about the extent of ICP allowing estimation of cerebral perfusion pressure which is unavailable currently. New Procedures Stereotactic Biopsy/ Craniotomy Stereotaxis is the exact location of a definite circumscribed area within the brain, with nominal damage to the remainder of the organ, by repositioning a probe or electrode along coordinates from exact distances from certain external points or markerS of the skull creating smaller incision which increases the potential for decreased blood loss and speedy recovery for the patient. [...]


[...] Expectations after Craniotomy All patients who have undergone craniotomy will feel very tired. Rest is very important for the patients. Headaches would be felt every now and then around the wound. The tiredness felt by the patient can lead to short-temperedness but it is the common reaction and nothing to worry about. The wound will feel sore for five days due to the cut nerves causing numbness that will eventually heal. As the wound starts to heal, a shooting pain would be felt near the wound and also scalp is very itchy which is indicative of healing process. [...]

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