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Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma

CPT4 code

Name of the Procedure:

Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma

Summary

A craniectomy involves the surgical removal of a section of the skull to access the brain. This specific procedure focuses on removing a meningioma, a type of brain tumor, located in the infratentorial or posterior fossa region of the brain.

Purpose

The procedure addresses the presence of a meningioma in the infratentorial or posterior fossa region, which can cause symptoms such as headaches, balance issues, and neurological deficits. The primary goal is to remove the tumor, alleviate symptoms, and prevent further complications.

Indications

  • Presence of a meningioma in the infratentorial or posterior fossa region.
  • Symptoms include persistent headaches, dizziness, coordination problems, and neurological impairments.
  • Imaging tests (e.g., MRI, CT scans) showing a growing meningioma that could impact brain function.

Preparation

  • Patients may need to fast for several hours before the surgery.
  • Medications may need to be adjusted, especially blood thinners.
  • Diagnostic tests such as MRI, CT scans, and blood tests are conducted to assess the tumor and overall health.

Procedure Description

  1. The patient is placed under general anesthesia.
  2. The surgeon makes an incision in the scalp and carefully removes a section of the skull to expose the brain.
  3. Specialized tools and equipment are used to locate and remove the meningioma.
  4. Intraoperative monitoring ensures no damage to critical brain structures.
  5. The bone flap may or may not be replaced, and the scalp is sutured closed.
  6. The patient is taken to recovery to be closely monitored.

Duration

The procedure typically takes 3 to 6 hours, depending on the tumor's size and complexity.

Setting

The craniectomy is performed in a hospital operating room equipped for neurosurgery.

Personnel

  • Neurosurgeon
  • Surgical nurse
  • Anesthesiologist
  • Operating room technician

Risks and Complications

  • Infection
  • Bleeding
  • Swelling in the brain
  • Neurological deficits or seizures
  • Damage to surrounding brain tissue
  • Anesthesia-related risks

Benefits

  • Relief from symptoms caused by the meningioma.
  • Reduced risk of complications from tumor growth.
  • Improved neurological function and quality of life.

Recovery

  • Initial hospital stay of 5 to 7 days for monitoring and rehabilitation.
  • Pain management with prescribed medications.
  • Gradual return to normal activities over several weeks to months.
  • Follow-up appointments to monitor recovery and check for recurrence of the tumor.

Alternatives

  • Observation and regular imaging for small, asymptomatic meningiomas.
  • Stereotactic radiosurgery to shrink the tumor.
  • Traditional craniotomy, which involves temporarily removing a section of the skull.

Patient Experience

Patients may experience discomfort and fatigue after surgery. Pain is managed with medications, and physical therapy may be necessary to regain strength and balance. It is essential to follow post-procedure care instructions for a smoother recovery.

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