Craniotomy
What is Craniotomy?
A craniotomy is a surgical procedure involving the removal of a portion of the skull (bone flap) to access the brain for treating conditions like tumors, hematomas, aneurysms, or trauma. The bone flap is typically replaced at the end of the procedure. In India, craniotomy is performed in neurosurgery departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, offering advanced care at affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for patients and families in India to make informed decisions.
Why do you need Craniotomy?
Craniotomy is indicated for:
- Brain tumors: Removal of benign (e.g., meningioma) or malignant tumors (e.g., glioblastoma).
- Hematomas: Evacuation of epidural, subdural, or intracerebral hematomas, often due to trauma or stroke.
- Aneurysms or AVMs: Clipping aneurysms or resecting arteriovenous malformations (AVMs) to prevent rupture.
- Trauma: Repair of skull fractures or removal of damaged brain tissue (e.g., contusions).
- Infections: Drainage of brain abscesses or treatment of severe infections (e.g., subdural empyema).
- Epilepsy: Resection of seizure foci in medically refractory cases (e.g., temporal lobectomy).
- Chiari malformation: Decompression by removing part of the occipital bone.
The procedure aims to address the underlying condition, relieve pressure on the brain, and preserve neurological function.
Why Do Craniotomy Costs Vary in India?
Costs range from ₹1.5 lakh to ₹8 lakh :
- Procedure Complexity: Simple craniotomy (e.g., hematoma evacuation, ₹1.5–3 lakh); complex (e.g., tumor resection, awake craniotomy, ₹3–8 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹50,000–₹2 lakh).
- Surgeon’s Expertise: Experienced neurosurgeons charge more.
- Additional Costs: ICU stay (₹10,000–₹50,000/day), MRI/CT (₹5,000–₹15,000), intraoperative tools (e.g., neuronavigation), adjuvant therapy.
- Insurance: Covered for tumors, trauma, or symptomatic conditions; Ayushman Bharat offers subsidies.
Craniotomy Procedure
- Before Surgery Evaluation:
- Diagnosis:
- MRI or CT scan identifies the lesion (e.g., tumor, hematoma) and its relation to critical brain structures.
- Functional MRI or tractography maps areas controlling speech, movement, or vision.
- Blood tests assess fitness for surgery (e.g., coagulation, hemoglobin).
- Neurological exam evaluates deficits (e.g., weakness, speech issues).
- Medications: Steroids (e.g., dexamethasone) reduce brain swelling; antiseizure drugs (e.g., levetiracetam) may be started.
- Consent: Risks, including neurological deficits or infection, are explained.
- Diagnosis:
- Surgical Techniques:
- Standard Craniotomy:
- Performed under general anesthesia, lasting 3–6 hours.
- The scalp is shaved and incised (e.g., curvilinear or horseshoe-shaped incision, 5–10 cm).
- The skull is drilled and a bone flap is removed (e.g., 5×5 cm) using a craniotome.
- The dura (brain covering) is opened to expose the brain.
- Procedure-Specific Steps:
- Tumor: Removed using microsurgical tools (e.g., ultrasonic aspirator); intraoperative MRI may confirm extent of resection.
- Hematoma: Evacuated with suction; bleeding vessels are cauterized.
- Aneurysm: Clipped at the base to prevent rupture.
- Trauma: Damaged tissue is removed, and fractures are repaired.
- The dura is closed (sometimes with a patch if needed).
- The bone flap is replaced and secured with titanium plates/screws; the scalp is sutured.
- Awake Craniotomy:
- Used for tumors near eloquent areas (e.g., speech/motor cortex).
- The patient is awake during part of the procedure to monitor function (e.g., speaking, moving) while the surgeon maps the brain.
- Endoscopic-Assisted Craniotomy:
- Smaller incision with an endoscope for deep or ventricular lesions.
- Intraoperative Tools:
- Neuronavigation: GPS-like system for precision.
- Neuromonitoring: Tracks brain function to avoid damage.
- Intraoperative imaging: MRI or ultrasound ensures complete resection.
- Standard Craniotomy:
- After Surgery:
- ICU monitoring for 1–3 days to watch for swelling, bleeding, or seizures.
- Hospital stay: 5–10 days; longer if complications or adjuvant therapy (e.g., radiation) starts.
- Pain management: IV analgesics (e.g., morphine) for 1–2 days, then oral (e.g., ibuprofen).
- Steroids are tapered over 1–2 weeks; antiseizure medications continue for 3–6 months.
- Follow-up MRI/CT at 1–3 months assesses outcome.
Recovery After Craniotomy
- Hospital Stay: 5–10 days; longer (2–4 weeks) for complications or ruptured cases (e.g., aneurysm).
- Post-Surgery Care:
- Pain: Scalp discomfort for 1–2 weeks, managed with analgesics.
- Activity: Light walking on day 2–3; avoid heavy lifting for 6–8 weeks.
- Neurological monitoring: For deficits (e.g., weakness, speech issues), which may improve over weeks/months.
- Steroids and antiseizure medications are adjusted based on symptoms.
- Rehabilitation: Physical, occupational, or speech therapy if deficits persist.
- Diet: Normal diet; high-protein foods (e.g., eggs, lentils) support healing; 2–3 liters water daily.
- Follow-Up:
- Visits at 2 weeks, 6 weeks, and 3 months; MRI/CT at 1–3 months to assess residual pathology.
- Oncology consultation for malignant tumors (e.g., radiation, chemotherapy).
Recovery varies: 6–12 weeks for benign conditions; months to years for malignant tumors or trauma. Symptom relief occurs in 70–90% of cases; outcomes depend on the condition (e.g., benign tumor: 90–95% 5-year survival; glioblastoma: 12–18 months median survival).
Risks and Complications
- Surgical Risks: Bleeding (3–5%), infection (2–5%, e.g., meningitis), brain swelling (5–10%).
- Neurological Complications:
- Deficits (5–15%): Weakness, speech/vision loss, depending on brain area.
- Seizures (5–10%), managed with medications.
- Hydrocephalus (5–10%): May require a shunt.
- General Risks: Anesthesia reactions, blood clots (DVT, 2–5%).
- Long-Term: Recurrence (e.g., malignant tumors: 50–90%), cognitive decline, personality changes (esp. frontal lobe).
Report fever, severe headache, or neurological changes promptly.
Frequently Asked Questions (FAQs)
What causes the need for craniotomy?
Brain tumors, hematomas, aneurysms, AVMs, trauma, infections, or epilepsy.
Can craniotomy be avoided?
Depends on the condition; some cases (e.g., small tumors, minor hematomas) may be monitored or treated with less invasive methods (e.g., radiosurgery for AVMs).
Will I lose brain function?
Risk exists (5–15%), but intraoperative tools (e.g., neuromonitoring, awake surgery) minimize damage; deficits may improve with rehabilitation.
How soon can I resume activities?
Light activities in 2–3 weeks, normal routines in 6–12 weeks.
Is craniotomy covered by insurance in India?
Yes, for tumors, trauma, or symptomatic conditions; confirm with your provider.
Signs of complications?
Fever, severe headache, seizures, or new neurological deficits.
Will I have a scar?
Yes, a scalp scar (5–10 cm); hair regrowth often hides it over time.
Lifestyle changes post-surgery?
Avoid heavy lifting for 6–8 weeks, adhere to medications, attend rehabilitation, and follow up regularly.
Conclusion
Craniotomy is a critical procedure for addressing serious brain conditions, with outcomes varying by diagnosis. India’s top hospitals (Apollo, Fortis, AIIMS) offer affordable, expert care using advanced techniques. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach craniotomy confidently. Consult a neurosurgeon for personalized guidance and optimal outcomes.
Looking for Best Hospitals for Craniotomy
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
3,50,000 |
9,50,000 |
Ahmedabad |
4,00,000 |
10,00,000 |
Ajmer |
3,50,000 |
9,50,000 |
Aligarh |
3,50,000 |
9,50,000 |
Allahabad |
3,50,000 |
9,50,000 |
Amritsar |
3,75,000 |
9,75,000 |
Aurangabad |
3,75,000 |
9,75,000 |
Bangalore |
4,00,000 |
10,00,000 |
Bareilly |
3,50,000 |
9,50,000 |
Belgaum |
3,75,000 |
9,75,000 |
Bhopal |
3,75,000 |
9,75,000 |
Bhubaneswar |
3,75,000 |
9,75,000 |
Bikaner |
3,50,000 |
9,50,000 |
Chandigarh |
4,00,000 |
10,00,000 |
Chennai |
4,00,000 |
10,00,000 |
Coimbatore |
4,00,000 |
10,00,000 |
Dehradun |
3,75,000 |
9,75,000 |
Delhi |
4,00,000 |
10,00,000 |
Dhanbad |
3,50,000 |
9,50,000 |
Durgapur |
3,50,000 |
9,50,000 |
Faridabad |
4,00,000 |
10,00,000 |
Ghaziabad |
4,00,000 |
10,00,000 |
Gorakhpur |
3,50,000 |
9,50,000 |
Guntur |
3,75,000 |
9,75,000 |
Gurgaon |
4,00,000 |
10,00,000 |
Guwahati |
3,75,000 |
9,75,000 |
Gwalior |
3,50,000 |
9,50,000 |
Hyderabad |
4,00,000 |
10,00,000 |
Indore |
3,75,000 |
9,75,000 |
Jabalpur |
3,50,000 |
9,50,000 |
Jaipur |
4,00,000 |
10,00,000 |
Jalandhar |
3,75,000 |
9,75,000 |
Jamshedpur |
3,75,000 |
9,75,000 |
Jodhpur |
3,50,000 |
9,50,000 |
Kanpur |
3,50,000 |
9,50,000 |
Kochi |
4,00,000 |
10,00,000 |
Kolkata |
4,00,000 |
10,00,000 |
Kollam |
3,75,000 |
9,75,000 |
Lucknow |
3,75,000 |
9,75,000 |
Ludhiana |
4,00,000 |
10,00,000 |
Madurai |
3,75,000 |
9,75,000 |
Mangalore |
3,75,000 |
9,75,000 |
Meerut |
3,50,000 |
9,50,000 |
Moradabad |
3,50,000 |
9,50,000 |
Mumbai |
4,00,000 |
10,00,000 |
Mysore |
4,00,000 |
10,00,000 |
Nagpur |
3,75,000 |
9,75,000 |
Nashik |
3,75,000 |
9,75,000 |
Navi Mumbai |
4,00,000 |
10,00,000 |
Noida |
4,00,000 |
10,00,000 |
Patna |
3,50,000 |
9,50,000 |
Pune |
4,00,000 |
10,00,000 |
Raipur |
3,75,000 |
9,75,000 |
Rajkot |
3,75,000 |
9,75,000 |
Ranchi |
3,50,000 |
9,50,000 |
Surat |
4,00,000 |
10,00,000 |
Thane |
4,00,000 |
10,00,000 |
Vadodara |
3,75,000 |
9,75,000 |
Varanasi |
3,50,000 |
9,50,000 |
Visakhapatnam |
3,75,000 |
9,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.