AFTERCARE FOR BRAIN SURGERY

IS IT NORMAL TO HAVE SWELLING AND DISCOLOURATION ON MY FACE?

After a craniotomy, the eyelids are usually swollen and may show noticeable bruising. Most swelling usually resolves quickly over 2 to 4 days, while the discolouration will diminish more gradually over 7 to 10 days. You may notice that one eye (usually on the side of the wound) will be more swollen than the other - this is normal and is not a cause of concern. The feeling of tightness is normal.

WHEN SHOULD I TAKE THE DRESSINGS DOWN?

Dressings on your cranial wound should remain intact for the first 72 hours. After this period, it is safe to remove the dressing and leave the wound exposed to air. Alternatively, you may wish to leave the dressing on until day 7-10 when your staples get removed.

HOW SHOULD I CARE FOR MY WOUND?

Your scalp wound is closed by staples (and occasionally by sutures). In general, these need to be removed after 7 days. It is safe to expose the wound directly to air after 48 hours. By day 7 from surgery, you can get the wound wet. It is recommended that you run warm water over the wounds (in the shower) to soften the scab. Do not scrub or rub on the wound. After 2 weeks, you can wash your hair and use hair products as usual. You can also colour or treat your hair after 4 weeks once the wound has healed.

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Any increasing wound pain or swelling, or any evidence of redness, heat, discharge, fluid leakage, wound breakdown, or signs of infection, should be urgently reported to Associate Professor Lai’s rooms or your local doctor. 

Do not swim and get the wound completely immersed in water until this has been checked with Assoc. Professor Lai after 6 weeks.

The skin around the edges of the wound might feel a bit numb until the healing is complete. The numbness might be painful or unpleasant and the wound might also feel itchy or very cold. This might persist for a few months.

CAN I USE ICE PACKS TO PLACE ON THE WOUND?

Icepacks can be gently applied to the suture line to help reduce swelling and bruising. Ice should always be wrapped in a small towel or in a zip locked bag and not applied directly to the suture line as this may cause some damage to the skin due to the decrease of sensitivity  and the swelling from the procedure.

WHEN SHOULD MY WOUND SUTURE/CLIPS BE REMOVED?

If you are discharged home before your clips or sutures are removed, your local doctor will be requested to remove them for you on day 7 (or day 10 for posterior fossa) following the surgery (unless you have been advised otherwise). You will be supplied with a clip remover, to give to your GP to remove them for you.

CAN I DRIVE AFTER MY CRANIOTOMY?

You can travel by car as a passenger immediately after surgery. However, you cannot drive your own car for the first 3 months after brain surgery. This restriction period may be longer if you developed a stroke or complications. If you drive a commercial vehicle (e.g. bus or truck), the restriction may be longer (i.e. 12 months).

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You may wish to follow this up with Associate Professor Lai at your 6 week appointment where you can discuss a return to driving plan.

CAN I WASH MY HAIR AFTER MY CRANIOTOMY?

Once your wound staples have been removed and the wound has healed well, allow at least 48 hours following staples removal before you wash your hair. 

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WHAT PROBLEMS MIGHT I EXPERIENCE WHEN I GET HOME?

Headaches are common and might last for several months before they gradually settle down. Some people find that their headaches persist for a longer period. Simple pain relief, such as Panadol or Nurofen, can be used for relief.

The bone flap (the piece of bone cut out during the operation) might feel like it moves. Because the pressure in your head can vary, the flap of bone might move in and out very slightly. You might experience a “clicking” sensation Although this feels strange, it is not dangerous. The bone flap is not loose. It is secured when it is replaced and will heal back into place.

During a craniotomy, a small cut is made in the muscle that helps with chewing (“temporalis muscle”). As it heals after the operation, the muscle can be slightly shortened causing the jaw to feel stiff. You might have difficulty in opening your mouth. This problem usually clears up after a couple of months. Chewing gum can help to resolve this problem.

Wound infection is not usually a problem. Antibiotics are often given around the time of the operation as a preventative measure. If you have any concerns about your wound, it is important that you make Assoc. Professor Lai aware of this or go to check with your GP.  Lumps or indentations around the wound are common after 3 months.

It is strongly recommended that you avoid smoking in the recovery period as this may impair wound healing.

A normal healthy diet that is high in fibre (to avoid constipation) is recommended.

IS IT NORMAL TO HAVE CHANGES IN MOOD AFTER SURGERY?

It is very common to find that your mood is changeable after surgery; for example you may feel angry, sad, anxious, depressed, lethargic.  These feelings are not unusual.  Your mood with stabilise as you recover.

IS IT NORMAL TO FEEL TIRED FOLLOWING BRAIN SURGERY?

Fatigue following brain surgery is common. The reasons for fatigue are not clear but may be attributable to general anaesthesia, surgical trauma, your baseline fitness, any postoperative complications, or medications.

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It has been observed that most patients experience extreme fatigue in the first two weeks following surgery. Over weeks, fatigue may slowly and gradually improve, and most patients recover to baseline at around 3 months. Some patients may acquire ongoing fatigue for up to 12 months following surgery. It is unclear why this may be the case.

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Fatigue can negatively impact on everyday function, and can range from minimal effect to increased day time sleepiness, reduced focus and concentration, poor short-term memory recall and difficulty with multi-tasking. Fatigue can also exacerbate existing neurological deficits (e.g. worsening balance, poorer facial muscle function). As fatigue improves, so does function.

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Patients are generally advised to maintain good hydration throughout the postoperative period and to ensure adequate rest at night time and during the day. Some patients may find improvement of fatigue from taking regular caffeine tablets.

HOW LONG DO I HAVE TO WAIT BEFORE I CAN COLOUR MY HAIR?

It is best to wait until after your 6 week post op review before you colour your hair to ensure the wound is properly healed.  The area may feel sensitive initially - this is normal.

WHAT SORT OF ACTIVITIES AM I ALLOWED TO DO?

Avoid strenuous activities that may require heavy lifting or bending over. In addition to aggravating swelling, these activities may elevate blood pressure and start bleeding. Rest in a semi upright position, this will help to decrease welling and bruising. Dark glasses may be worn to help reduce sensitivity of light to your eyes. 

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It is advisable not to smoke for 4 weeks after surgery as this can significantly slow the healing. Try to avoid sun exposure for the next 6 weeks. 

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IS THERE ANYTHING I CAN DO TO OPTIMISE MY RECOVERY?

Healing is influenced by a number of factors from genetics to your overall health to your ability to follow the important post-operative instructions. 

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Getting adequate sleep and getting adequate rest can help your healing; So be sure you allow adequate recovery and resting after your procedure. 

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Stay hydrated (drink plenty of water) and eat nutritious meals. Consuming fresh fruit and vegetables and maintain a balanced diet before and after your surgery ensures your body is receiving the vitamins and nutrients it needs to aid recovery.