00214 Anesthesia for intracranial procedures; burr holes, including ventriculography

Name of the Procedure:

Anesthesia for Intracranial Procedures: Burr Holes, Including Ventriculography

Summary

This procedure involves administering anesthesia for the creation of small openings in the skull, known as burr holes, which allows doctors to perform diagnostic imaging or treat conditions within the brain.

Purpose

The primary goal is to facilitate intracranial procedures such as draining excess fluid, performing biopsies, or conducting ventriculography, which involves imaging the brain's ventricular system. This helps address issues like hydrocephalus, brain tumors, or hemorrhages.

Indications

• Hydrocephalus (accumulation of cerebrospinal fluid)
• Brain tumors or masses requiring biopsy
• Intracranial hemorrhages
• Determining causes of increased intracranial pressure
• Blockages in the cerebrospinal fluid pathways

Preparation

• Patients are usually advised to fast for 6-8 hours prior to the procedure.
• Adjustments in regular medications may be necessary (e.g., blood thinners).
• Preoperative imaging studies and blood tests are typically performed.
• A consent form must be signed after discussing risks and benefits with the healthcare provider.

Procedure Description

1. Patient is positioned appropriately on the operating table.
2. An intravenous (IV) line is placed for administering medications.
3. General anesthesia is induced, ensuring the patient is fully unconscious and pain-free.
4. The scalp is cleaned and shaved around the surgical area.
5. Small incisions are made, and burr holes are drilled into the skull.
6. Depending on the purpose, the necessary intracranial procedure (e.g., ventriculography) is performed.
7. After completion, the incision is closed and bandaged.
8. The patient is observed in the recovery room until anesthesia wears off.

Duration

The procedure typically lasts between 1-3 hours, depending on its complexity.

Setting

The procedure is performed in a hospital's operating room equipped with advanced surgical and imaging technology.

Personnel

• Neurosurgeon
• Anesthesiologist
• Surgical nurses
• Radiologic technologist (for ventriculography)

Risks and Complications

• Infection
• Bleeding
• Adverse reactions to anesthesia
• Brain swelling or damage
• Potential for seizures
• Stroke

Benefits

• Accurate diagnosis of intracranial conditions
• Relief from symptoms like headaches or vision problems due to fluid buildup
• Improved outcomes for various brain-related conditions

Recovery

• Close monitoring in the recovery room, followed by transfer to a hospital room.
• Pain management with prescribed medications.
• Rest and limited physical activity for several weeks.
• Follow-up appointments for monitoring and further imaging.

Alternatives

• Medical management with medications
• Non-invasive imaging studies like MRI or CT scans
• Endoscopic third ventriculostomy (for hydrocephalus)

Patient Experience

Patients will be unconscious during the procedure due to general anesthesia. Post-procedure, they may experience headaches, soreness at the incision site, or mild dizziness. Pain management and comfort measures will be provided. Recovery involves close observation and follow-up care to ensure proper healing and address any complications.