Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar
CPT4 code
Name of the Procedure:
Craniectomy or Craniotomy for Evacuation of Hematoma, Infratentorial; Intracerebellar
Summary
This procedure involves surgically removing part of the skull to access and remove a blood clot (hematoma) located in the cerebellum, the lower part of the brain.
Purpose
This procedure aims to relieve pressure on the brain caused by the hematoma, which, if left untreated, can lead to severe neurological damage or even be life-threatening.
Indications
- Symptoms such as severe headache, nausea, vomiting, loss of consciousness, or imbalance.
- Diagnosis of an infratentorial intracerebellar hematoma via imaging tests.
- Patients experiencing neurological deficits due to the hematoma.
Preparation
- The patient may need to fast for 8-12 hours before the procedure.
- Blood tests, imaging studies (MRI or CT scan), and neurological assessments will be performed.
- Medication adjustments may be necessary, especially if blood thinners are being taken.
Procedure Description
- The patient is given general anesthesia.
- The patient’s head is secured in a fixed position.
- An incision is made in the scalp, and a portion of the skull is removed (craniotomy or craniectomy) to access the cerebellum.
- The hematoma is carefully evacuated using specialized surgical instruments.
- The skull piece is either replaced (craniotomy) or left out temporarily or permanently (craniectomy).
- The incised tissues are sutured, and the area is bandaged.
Duration
The procedure typically takes 3-6 hours, depending on complexity.
Setting
The procedure is performed in a hospital operating room equipped for neurosurgery.
Personnel
- Neurosurgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Swelling of the brain
- Neurological deficits
- Complications from anesthesia
Benefits
- Relieves brain pressure and prevents further neurological damage.
- Symptoms such as headache, nausea, and neurological deficits should improve shortly after the procedure.
Recovery
- The patient will be monitored in an intensive care unit (ICU) immediately following surgery.
- Pain management will be provided.
- The recovery time varies but generally involves several weeks to months.
- Follow-up appointments will be necessary to monitor progress.
Alternatives
- Non-surgical management with medications, though often less effective in severe cases.
- Stereotactic aspiration may be an option for smaller hematomas.
- Each alternative can vary significantly in effectiveness and risk.
Patient Experience
The patient will be under general anesthesia during the surgery and will not feel pain. Postoperative discomfort is managed with pain medication. The initial recovery can involve ICU stay, and rehabilitation may be needed to regain full neurological function.