Neurotrauma Surgery in Indore

What is neurotrauma surgery?

A serious head injury can cause bleeding inside the skull. A blood clot can collect between the skull and the brain (extradural or subdural haematoma) or inside the brain (contusion). The clot and swelling raise the pressure inside the head and can press on the brain, which can be life-threatening.

Surgery for head injury may involve opening the skull to remove a blood clot (craniotomy), lifting a broken piece of skull that is pressing on the brain, or removing a part of the skull bone for a while to give a swollen brain room (decompressive craniectomy). In older people, a slowly forming clot (chronic subdural haematoma) can often be drained through small holes in the skull.

A spine injury can break or shift the spine bones and press on the spinal cord or nerves. Surgery may be done to relieve this pressure (decompression) and to hold the spine steady with screws and rods (spine fixation). Many spine fractures are stable and heal with a brace and rest instead.

Who may need it

People with a head injury whose CT scan shows a large blood clot pressing on the brain.

People who become more drowsy or confused, have fits, vomit repeatedly, or develop weakness after a head injury.

People with a depressed skull fracture (a piece of skull pushed inwards) or an open wound into the brain.

People with a spine fracture that is unstable, or that is pressing on the spinal cord or nerves and causing weakness or numbness.

Many people with a head injury only need observation, medicines and repeat scans. Many spine fractures are treated with a brace. The decision is made after examination and scans.

Surgery is one option, not the only one. It is decided after an examination and a careful look at your scans, and non-surgical treatment is discussed first where it is suitable.

How it is done

1
In the emergency department, the team first makes sure the patient is breathing well, has stable blood pressure, and that the neck is kept still.
2
A CT scan of the head and, if needed, the spine is done to find bleeding, swelling or fractures.
3
If surgery is needed, the family is counselled and consent is taken. You are given general anaesthesia.
4
For a head injury, the surgeon opens the skull to remove the blood clot and stop the bleeding. If the brain is very swollen, the bone may be kept aside and replaced in a later operation (cranioplasty).
5
For a spine injury, the surgeon removes bone or disc pressing on the spinal cord or nerves and fixes the spine with screws and rods so it can heal in the right position.
6
After surgery, the patient is usually cared for in the ICU (intensive care unit), with close watch on breathing, brain pressure and movement.

Possible risks

Every operation carries some risk. Your surgeon will explain which of these apply to you.

Further bleeding or a new blood clot, which may need another operation.

Brain swelling, seizures (fits), and infection of the wound, bone or brain covering.

CSF leak (leak of brain or spinal fluid).

Weakness, speech, memory or behaviour problems, or loss of movement or feeling below a spine injury. These often depend mainly on how severe the original injury was.

Problems with screws and rods in the spine, such as loosening, which may need further surgery.

Chest infection, bed sores and blood clots in the legs during a long hospital stay. Anaesthesia also carries its own risks, which are higher in emergencies.

Preparing for surgery

After any serious accident, call 108 or 112 for an ambulance. The first hour after injury, often called the golden hour, is the time when quick, proper care matters most.

Do not move the injured person's neck or back unnecessarily. Keep the head and neck in line. If they vomit, turn the whole body onto the side together, keeping the neck straight.

Do not give food or water, as the person may need anaesthesia and surgery.

Take the patient to the nearest hospital that has a CT scan and emergency neurosurgical care, rather than travelling far.

Tell the doctors about any medicines the patient takes, especially blood thinners, and any illness such as diabetes or heart disease. Bring old reports if available.

Keep a family member available at the hospital to give consent and support, and keep phones charged. The hospital may ask the family to help arrange blood donors.

Recovery

Recovery depends mostly on how severe the injury was. Some patients go home within a week, while others need weeks in hospital, including time in the ICU. Some need a tracheostomy (a breathing tube in the neck) or feeding tube for a while.

Many patients need physiotherapy, and some need speech therapy and help with memory, mood or behaviour. Improvement can continue slowly over many months. After spine fixation, a brace may be advised and heavy work avoided for some months.

If part of the skull was removed, protect that area, often with a helmet, until the bone is replaced in a later operation. Keep all follow-up visits. Always wear a helmet on a two-wheeler and a seat belt in a car, as prevention is the most effective protection.

Questions patients ask

Does every head injury need surgery?

No. Most head injuries are mild and only need observation and rest. Even some moderate and severe injuries are managed with medicines, ICU care and repeat CT scans. Surgery is needed mainly when a blood clot or swelling is pressing on the brain.

What is the golden hour?

It is the first hour or so after a serious injury, when quick help can make the biggest difference. Call 108 or 112, keep the neck still, and take the patient to the nearest hospital with a CT scan and emergency care.

What are the danger signs after a head injury?

Increasing drowsiness, confusion, repeated vomiting, fits, severe or worsening headache, weakness in arms or legs, unequal pupils, or clear fluid or blood from the nose or ears. Any of these needs emergency care at once.

Will the patient recover fully?

It depends on the type and severity of the injury, the patient's age and general health, and how quickly treatment started. Some people recover fully, while others are left with some long-term problems. The treating team will update the family regularly.

Why is the skull bone sometimes not put back?

When the brain is very swollen, the bone is kept aside to give the brain room and lower the pressure. It is usually replaced in a later, planned operation called cranioplasty once the swelling settles.

Disclaimer: This information is for general awareness and is not a substitute for a medical consultation. Read moreSource: Content on this website was prepared with the help of AI tools (AI-assisted) and is medically reviewed by Dr. Kshitiz Nigam, MBBS, MS, MCh (Neurosurgery), Reg. No. MP-33282.