Brain surgery - discharge

Surgery was done for one of the following reasons:

• Correct a problem with a blood vessel.
• Remove a tumor, a blood clot, an abscess, or other abnormality along the surface of the brain or in the brain tissue itself.
• Treat hydrocephalus (enlarged cerebral ventricles) or increased cerebrospinal fluid (CSF) pressure.
• Create more space for the brain because of swelling or Chiari syndrome.

You may have spent some time in the intensive care unit (ICU) and some more time in a regular hospital room. You may be taking new medicines.

You'll probably notice itchiness, pain, burning, and numbness along your skin incision. You may hear a clicking sound where the bone is slowly reattaching. Complete healing of the bone may take 6 to 12 months.

You may have a small amount of fluid under the skin near your incision. The swelling may be worse in the morning when you wake up.

You may have headaches. You may notice this more with deep breathing, coughing, or being active. You may have less energy when you get home. This may last for several months.

Your surgeon may have prescribed medicines for you to take at home. These may include antibiotics, steroids, and medicines to prevent seizures. Ask your surgeon how long you should expect to take these medicines. Follow instructions on how to take these medicines.

If you had a brain aneurysm, you may also have other symptoms or problems.

Take only the pain relievers your surgeon recommends. Aspirin, ibuprofen (Advil, Motrin), and some other medicines you may buy at the store may cause bleeding. If you were on blood thinners previously, do not restart them without getting the okay from your surgeon.

Eat the foods you normally do unless your surgeon tells you to follow a special diet.

Slowly increase your activity. It will take time to get all your energy back.

• Start with walking.
• Use hand railings when you are on stairways.
• Do not lift more than 20 pounds (9 kilograms) for the first 2 months after surgery.
• Try not to bend over from your waist. It puts pressure on your head. Instead, keep your back straight and bend at the knees.

Ask your surgeon when you can begin driving and return to having sex.

Get enough rest. Sleep more at night and take naps during the day. Also, take short rest periods during the day.

Keep the incision clean and dry:

• Wear a shower cap when you shower or bathe until your surgeon takes out any stitches or staples.
• Afterward, gently wash your incision, rinse well, and pat dry.
• Always change the bandage if it gets wet or dirty.

You may wear a loose hat or turban on your head. Do not use a wig for 3 to 4 weeks.

Do not put any creams or lotions on or around your incision. Do not use hair products with harsh chemicals (coloring, bleach, perms, or straighteners) for 3 to 4 weeks.

You may place ice wrapped in a towel on the incision to help reduce swelling or pain. Never sleep on an ice pack.

Sleep with your head raised on several pillows. This helps reduce swelling.

Contact your surgeon if you have:

• Fever of 101°F (38.3°C) or higher, or chills
• Redness, swelling, discharge, pain, or bleeding from the incision or if the incision comes open
• Headache that does not go away and is not relieved by medicines the surgeon gave you
• Vision changes (double vision, blind spots in your vision)
• Problems thinking straight, confusion, or more sleepiness than usual
• Weakness in your arms or legs that you did not have before
• New problems walking or keeping your balance
• A hard time waking up
• A seizure
• Fluid or blood dripping into your throat
• New or worsening problem speaking
• Shortness of breath, chest pain, or coughing up more mucus
• Swelling around your wound or underneath your scalp that does not go away within 2 weeks or is getting worse
• Side effects from a medicine (do not stop taking a medicine without talking to your surgeon first)

Craniotomy - discharge; Neurosurgery - discharge; Craniectomy - discharge; Stereotactic craniotomy - discharge; Stereotactic brain biopsy - discharge; Endoscopic craniotomy - discharge

Abts D. Post-anesthetic care. In: Keech BM, Laterza RD, eds. Anesthesia Secrets. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 34.

Jackson CM, Weingart JD, Brem H. Basic principles of cranial surgery for brain tumors. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 151.

Patterson JT. Neurosurgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 68.

Updated by: Luc Jasmin, MD, Ph.D., FRCS (C), FACS, Department of Neuroscience, Guam Regional Medical City, Guam; Department of Surgery, Johnson City Medical Center, TN; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.