Warning, this post includes a detailed description of my impending surgery.
I have been asked repeatedly just exactly what will be done during my surgery. For those who would like to know, keep reading. If you would rather not know the details, I suggest you avert your gaze.
The information I have is as follows.
I am being admitted to the Memorial Hospital in Adelaide on the afternoon of Friday 30 May 2014 and will see both my surgeon and anaesthetist when they have finished their work for the day. I will be fasting. My surgery is scheduled for Saturday 31 May. I do not know what time yet.
I am having what is called a craniotomy. I will be under a general anaesthetic and not awake (as some people have asked) and that is fine with me! The operation will take between three to six hours, which sounds like a long time but I have been reassured by an ex-theartre nurse friend that this amount of time is quite normal and reasonably short for neurosurgery. The bulk of the time will be in getting in and out so to speak, the actual clipping of the aneurysm will take very little time.
My head will be stabilised with some sort of ‘halo’ device which will have several little spokes drilled into my skull. Again, fine with me, I don’t want it moving either. A small patch of hair will be shaved and no, they won’t cut any of my pink bits – again, a question I have been asked.
The likely entry point is in front of my right ear and the skin and my jaw muscle will be cut to expose the skull. Four small holes are then drilled at the corner points and a square of skull is then cut out and preserved. The size will be approximately 4 x 4 centimetres. The membrane around the brain is then cut and retracted to expose my brain.
The aneurysm is located deep within my brain, at the bottom in a place called the Circle of Willis, where the carotid arteries come together in the brain. For a picture see http://www.nlm.nih.gov/medlineplus/ency/imagepages/18009.htm
The aneurysm is on the anterior central communicating artery. Sounds like the upper class part of town to me.
To access the area, the surgeon will likely go in under the frontal lobe, moving that part of the brain out of the way, rather than going in through brain tissue. This approach is much less likely to cause damage to my brain tissue. I can’t remember if the surgeon said she needs to restrict the flow of blood into the affected artery whilst she puts the clip in place. I will then have a small titanium clip across the base of the aneurysm which prevents blood flow to it. The aneurysm then deflates and is no longer a threat. Clipping is a permanent fix for this aneurysm. Once the clip is secure, they come back out, putting things back where they found them, put the piece of skull back (I’m not sure if they cement it or anything) and I get stitched up.
As a standard precaution, I will spend the night in the Intensive Care Unit (ICU) to ensure I am safe.
My surgeon tells me that my age is in my favour. She is going in from the right-hand side so that if I suffer any damage, it will affect my left (already stroke affected side). The main risks with the surgery include:
- Small risk of bleeding;
- May require a blood transfusion;
- Stroke or other brain damage;
- Vasospasm causing stroke;
- More common – leg weakness or paralysis, both or either side;
- Painful face and difficulty eating due to jaw muscle being cut;
- Face swelling so much as to close both eyes.
With no complications, I will be in hospital a full week after the surgery and should be feeling better after about six weeks. I am not allowed to drive for three months.
This is a link to a site that has a lot of information about craniotomies. http://www.precisionneurosurgery.com.au/html/surgical_craniotomy.htm