craniotomy
A craniotomy is performed to gain access to portions of the central nervous system (CNS) inside
the cranium, usually to allow removal of a space-occupying lesion such as a brain tumor.
The neurosurgeon must select a route that also produces the *least amount of disruption to the
intracranial contents.* - ANS-Craniotomy
Common procedures include tumor resection or removal, cerebral decompression, evacuation
of hematoma or abscess, and clipping or removal of an aneurysm or AVM. - ANS-Craniotomy
Types
Complications associated with a craniotomy include *intracranial hypertension, surgical
hemorrhage, fluid imbalance, cerebrospinal fluid leak, and DVT.* - ANS-Craniotomy
Complications
Postoperative cerebral edema is expected to peak 48 to 72 hours after surgery.
Post-craniotomy management of intracranial hypertension is usually accomplished through CSF
drainage, patient positioning, and steroid
administration - ANS-Intercranial hypertension
postcraniotomy
Surgical hemorrhage after a transcranial procedure can occur in the intracranial vault and
manifests as signs and symptoms of increasing ICP. - ANS-Surgical hemorrhage
postcraniotomy
○ Fluid imbalance in the postcraniotomy patient usually results from a disturbance in production
or secretion of antidiuretic hormone (ADH)- vasopressin and fluid retain.
○ Unabated renal water loss even when blood volume is low and serum osmolality is high. This
condition is known as diabetes insipidus (DI).
○ The syndrome of inappropriate antidiuretic hormone (SIADH) manifests as inappropriate water
retention with hyponatremia in the presence of normal renal function. - ANS-Fluid Imbalance
post-craniotomy
decreased urine specific gravity normal: (1.002- 1.030)
Diabetes insipidus is an uncommon condition in which the kidneys are unable to prevent the
excretion of water.
Causes
During the day, your kidneys filter all your blood many times. Normally, most of the water is
reabsorbed, and only a small amount of concentrated urine is excreted. DI occurs when the
kidneys cannot concentrate the urine normally, and a large amount of dilute urine is excreted.
, The amount of water excreted in the urine is controlled by antidiuretic hormone (ADH). ADH is
also called vasopressin. ADH is produced in a part of the brain called the hypothalamus. It is
then stored and released from the pituitary gland. This is a small gland at the base of the brain.
DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by a failure
of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. -
ANS-crainitoltoy
Diabetes Insipidus
Ectopic ADH secretion is the release of antidiuretic hormone (ADH, also called vasopressin, or
AVP) from a place in the body where it is not normally produced. ADH is a substance produced
naturally by the hypothalamus and released by the pituitary gland. This hormone controls the
amount of water your body loses through the urine.
Causes
Ectopic ADH secretion is rare. The most common cause of ectopic ADH secretion is cancer.
Certain lung cancers and some head and neck tumors are the most common cancers that
cause this problem. In very rare cases, other tumors can cause ectopic ADH secretion
CAN CAUSE HYPONATREMIA - ANS-crainiotomy
SIADH
Leakage of CSF results from an *opening in the subarachnoid space*, as evidenced by clear
fluid draining from the surgical site.
○ When this complication occurs after trans-sphenoidal surgery, it is evidenced by excessive,
clear drainage from the *nose or persistent postnasal drip.*
○ To differentiate CSF drainage from postoperative serous drainage, a specimen is tested for
glucose content.
○* A CSF leak is confirmed by glucose values of 30 mg/dL or greater.
Management of the patient with a CSF leak includes bed rest and head elevation.*
○Lumbar puncture or placement of a lumbar subarachnoid catheter may be used to reduce CSF
pressure until the dura heals.
•The risk of meningitis associated with CSF leak often necessitates surgical repair to reseal the
opening. - ANS-CSF leak
postcraniotomy
Patients who have undergone neurosurgery are at particularly high risk for the development of
DVT.
Risk factors include leg weakness and longer operative procedure time - ANS-DVT
post-craniotomy
Nursing interventions focus on preserving adequate CPP(normal 60-100), promoting arterial
oxygenation, providing comfort and emotional support, maintaining surveillance for
complications, initiating early rehabilitation, and educating the patient and family - ANS-post-op
nursing management
A craniotomy is performed to gain access to portions of the central nervous system (CNS) inside
the cranium, usually to allow removal of a space-occupying lesion such as a brain tumor.
The neurosurgeon must select a route that also produces the *least amount of disruption to the
intracranial contents.* - ANS-Craniotomy
Common procedures include tumor resection or removal, cerebral decompression, evacuation
of hematoma or abscess, and clipping or removal of an aneurysm or AVM. - ANS-Craniotomy
Types
Complications associated with a craniotomy include *intracranial hypertension, surgical
hemorrhage, fluid imbalance, cerebrospinal fluid leak, and DVT.* - ANS-Craniotomy
Complications
Postoperative cerebral edema is expected to peak 48 to 72 hours after surgery.
Post-craniotomy management of intracranial hypertension is usually accomplished through CSF
drainage, patient positioning, and steroid
administration - ANS-Intercranial hypertension
postcraniotomy
Surgical hemorrhage after a transcranial procedure can occur in the intracranial vault and
manifests as signs and symptoms of increasing ICP. - ANS-Surgical hemorrhage
postcraniotomy
○ Fluid imbalance in the postcraniotomy patient usually results from a disturbance in production
or secretion of antidiuretic hormone (ADH)- vasopressin and fluid retain.
○ Unabated renal water loss even when blood volume is low and serum osmolality is high. This
condition is known as diabetes insipidus (DI).
○ The syndrome of inappropriate antidiuretic hormone (SIADH) manifests as inappropriate water
retention with hyponatremia in the presence of normal renal function. - ANS-Fluid Imbalance
post-craniotomy
decreased urine specific gravity normal: (1.002- 1.030)
Diabetes insipidus is an uncommon condition in which the kidneys are unable to prevent the
excretion of water.
Causes
During the day, your kidneys filter all your blood many times. Normally, most of the water is
reabsorbed, and only a small amount of concentrated urine is excreted. DI occurs when the
kidneys cannot concentrate the urine normally, and a large amount of dilute urine is excreted.
, The amount of water excreted in the urine is controlled by antidiuretic hormone (ADH). ADH is
also called vasopressin. ADH is produced in a part of the brain called the hypothalamus. It is
then stored and released from the pituitary gland. This is a small gland at the base of the brain.
DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by a failure
of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. -
ANS-crainitoltoy
Diabetes Insipidus
Ectopic ADH secretion is the release of antidiuretic hormone (ADH, also called vasopressin, or
AVP) from a place in the body where it is not normally produced. ADH is a substance produced
naturally by the hypothalamus and released by the pituitary gland. This hormone controls the
amount of water your body loses through the urine.
Causes
Ectopic ADH secretion is rare. The most common cause of ectopic ADH secretion is cancer.
Certain lung cancers and some head and neck tumors are the most common cancers that
cause this problem. In very rare cases, other tumors can cause ectopic ADH secretion
CAN CAUSE HYPONATREMIA - ANS-crainiotomy
SIADH
Leakage of CSF results from an *opening in the subarachnoid space*, as evidenced by clear
fluid draining from the surgical site.
○ When this complication occurs after trans-sphenoidal surgery, it is evidenced by excessive,
clear drainage from the *nose or persistent postnasal drip.*
○ To differentiate CSF drainage from postoperative serous drainage, a specimen is tested for
glucose content.
○* A CSF leak is confirmed by glucose values of 30 mg/dL or greater.
Management of the patient with a CSF leak includes bed rest and head elevation.*
○Lumbar puncture or placement of a lumbar subarachnoid catheter may be used to reduce CSF
pressure until the dura heals.
•The risk of meningitis associated with CSF leak often necessitates surgical repair to reseal the
opening. - ANS-CSF leak
postcraniotomy
Patients who have undergone neurosurgery are at particularly high risk for the development of
DVT.
Risk factors include leg weakness and longer operative procedure time - ANS-DVT
post-craniotomy
Nursing interventions focus on preserving adequate CPP(normal 60-100), promoting arterial
oxygenation, providing comfort and emotional support, maintaining surveillance for
complications, initiating early rehabilitation, and educating the patient and family - ANS-post-op
nursing management
