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Craniotomy Postoperative Care

Caring for yourself at home:

When you go home there are several things you need to know to ensure your safety, your comfort and promote a speedy recovery.

Body Changes:

Your appetite may be poor. Drink plenty of fluids to prevent dehydration. Your desire for solid food will return. Refrain from drinking alcohol as it may interfere with your anti-seizure medication. You may have difficulty sleeping at night. This is not abnormal. Try not to sleep or nap during the day, but if you feel fatigued, which is normal, take naps as necessary. Your energy level will be decreased for the first month. If you experience constipation, take over the counter stool softeners or laxatives as needed. Avoid hyperthermia (getting too hot). Facial swelling may persist for several weeks.

Blood clots in legs:

Surgery may cause the flow of blood to slow and collect in the veins of your legs, creating a blood clot. If a clot occurs, you may need to be admitted to the hospital to receive intravenous blood thinners. Another treatment option may be to surgically place a filter in the venous system that would trap clots and prevent them from traveling to your heart, lungs or brain. A clot that breaks loose and travels throughout the body is called an embolus. This is a serious complication and requires prompt treatment. Moving around, especially walking, is considered one of the best preventative measures against the development of blood clots.

Signs of blood clots in the legs:

A swelling in thigh, calf or ankle that does not go down with elevation. Pain, tenderness in calf. These signs are not 100% certain, but are warnings. If they are present, promptly notify your surgeon.

Please do NOT massage the legs as this can mobilize a blood clot.

Form 03-300 Rev 2/09

Pulmonary Embolus:

An unrecognized blood clot could break off the vein and go to the lungs. This is an emergency and you should CALL 911, if suspected. There may be no obvious warning signs of a pulmonary embolus and if there are symptoms, they often mimic those of other cardiopulmonary (heart-lung) disorders.

Symptoms and signs of a pulmonary embolus:

Shortness of breath Sudden chest pain Difficult and/or rapid breathing Coughing, including coughing up blood Rapid heart rate Sweating Slight fever Fainting Dizziness Leg swelling and pain Bluish skin Swollen neck veins

Caring for your incision at home:

You may shampoo your hair with baby shampoo. You may leave the incision open to dry. Do not apply any lotions, ointments or other products to your incision site, unless directed by your surgeon. Keep the incision site clean, dry and free from any fabric fibers that may come off with hats or other head coverings. Protect your head/incision from extreme cold, wind and sun. Notify your surgeon immediately if you notice redness, swelling, drainage, separation of wound edges or an increase of pain at incision site. Staples and sutures are removed at your ten day follow-up visit to the surgeon.

Medications:

You will be given a list of medications and prescriptions that you are to take after leaving the hospital. Your nurse will explain to you why you are taking each medication and how to take them. Be sure that you clearly understand these instructions. Upon discharge from the hospital, you may resume all medications that you were on before surgery unless your surgeon has specifically discontinued them. If you have specific questions about the medications you were taking before the surgery, please contact your primary care physician.

Form 03-300 Rev 2/09

Headache:

Craniotomy patients may experience headache after surgery. Tylenol is generally sufficient to relieve the postoperative discomfort of headache. Sometimes a stronger pain medication may be needed. If so, your surgeon will provide you with a prescription for the necessary medication. Be certain that these medications are taken exactly as prescribed. It is our goal to treat the headache, but not to mask any other processes that may be developing.

When to call your physician:

New onset of confusion, fainting, blacking out, extreme fatigue, memory loss or difficulty speaking New onset of double or blurred vision, loss of vision (either partial or total) New onset of hallucinations New onset of numbness, tingling or weakness in your extremities or face Stiff neck and/or fever of 101.5 F or more Severe sensitivity to light (photophobia) Severe headache or change in headache New onset of seizures New problems controlling your bowels or bladder Productive cough with yellow or green sputum Swelling, redness in your calf or thigh Sudden onset of anything else that does not seem or feel right

Call 911 or go to the nearest emergency room for:

Sudden difficulty in breathing A seizure Change in mental status Loss of consciousness

Form 03-300 Rev 2/09

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