Craniotomy in U.A.E

A craniotomy is a major brain surgery in which a bone flap from the skull is temporarily removed to have an access to the brain. This procedure is mainly performed in patients who suffer from traumatic brain injuries or brain lesions. It is a highly critical procedure and a patient may take months to recover from it. This surgery is also conducted prior to the placement of deep brain stimulators, which is often recommended to patients suffering from epilepsy and Parkinson’s disease. This procedure has a wide range of other applications as well such as brain imaging and electrical stimulation.

Craniotomy in U.A.E

A craniotomy is a highly sensitive procedure that is performed in some of the top neurosurgery hospitals in U.A.E. Because of the sensitivity of the procedure and the risks involved, this surgery should only be conducted by highly experienced and skilled surgeons. The top neurosurgeons in U.A.E are educated from some of the most prestigious medical universities in the world. They hold several years of experience in conducting all types of brain surgeries and have so far treated thousands of patients from around the world.

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About the Craniotomy

Craniotomy surgery is one of the most common types of brain surgery conducted to treat a brain tumor. It mainly aims at removing a lesion, tumor, or a blood clot in the brain by opening a flap above the brain to access the targeted area. This flap is removed on a temporary basis and again put in place when the surgery is done. Around 90 percent of the cases of brain tumors are diagnosed in adults aged between 55 and 65. Among children, a brain tumor is diagnosed within an age range of 3 to 12 years.

Craniotomy procedures are conducted with the help of magnetic resonance imaging (MRI) scans to reach the location precisely in the brain that requires treatment. A three-dimensional image for the same is achieved of the brain in conjunction with localizing frames and computers to view a tumor properly. A clear distinction is made between abnormal or tumor tissue and normal healthy tissue and to access the exact location of the abnormal tissue.

Who requires a craniotomy?

In a minimally invasive craniotomy procedure, a burr hole or a keyhole may be created to access the brain to fulfill the following purposes:

  • To drain out cerebrospinal fluid in case of hydrocephalus by inserting a shunt into the ventricles
  • To treat Parkinson’s disease by inserting a deep brain stimulator (DBS)
  • To insert an intracranial pressure monitor
  • To conduct needle biopsy, where a small sample of abnormal tissue is removed for study
  • For stereotactic hematoma aspiration, in which a blood clot is drained out
  • For insertion of an endoscope to clip aneurysms and for the removal of small tumors

When there are complex craniotomies involved, the procedure may be referred to as a skull base surgery.  In this kind of surgery, a small portion of the skull is removed from the bottom of the brain. This is the region where delicate arteries, veins, and cranial nerves exit the skull. Complicated planning is done to plan such craniotomies and understand the location of the lesions. This type of approach is usually employed for:

  • The removal or treatment of large brain tumors and aneurysm in the brain
  • Treatment after a skull fracture or major injury like a gunshot
  • The removal of a malignant tumor affecting the bony skull

Primary brain tumors are much less common than secondary brain tumors. Primary ones are found to originate very close to the brain itself or in the tissues very close to it, such as the covering membranes of the brain, including the meninges, cranial nerves, pineal, or pituitary gland. It begins with normal cells, which at a later period undergoes some mutational errors in their DNA. The mutation triggers cells to grow and divide at a very high rate while healthy cells keep dying around it. This results in a mass of abnormal cells which gives rise to a tumor. Unlike primary tumors, the secondary tumors begin as cancer elsewhere and spread to the brain.

Symptoms of brain tumor

  • Different patterns of a headache
  • Headaches get more frequent and acutely painful
  • Nausea
  • Blurred vision, double vision, or loss of peripheral vision
  • Loss of sensation in the arm or any leg gradually
  • Balance difficulty
  • Speech problems with confusion in simple matters
  • Hearing problems
  • Personality change
  • Sudden seizures and attacks or bouts of pain

Types of Craniotomy

No matter what the goal of the surgery is, it is best to ensure that the incision is made to address the intracranial lesion keeping some principles in mind. A wide variety of intracranial processes can be done via a craniotomy with a different variety of incisions. Some of these variations include frontal craniotomy, pterional craniotomy, temporal craniotomy, decompression craniectomy, and suboccipital craniotomy.

How is Craniotomy performed?

  • An intravenous line is first placed in the arm and general anaesthesia is employed while the patient lies on the operating table.
  • When the patient is no more awake, the head is placed in a 3-pin skull fixing the device. This is attached to a table and keeps the head in a fixed position all throughout the procedure.
  • An insertion of a lumbar drain is made in the lower back to drain out the cerebrospinal fluid. A relaxation drug for the brain named mannitol can be administered at this stage.
  • With an antiseptic, the skull is prepared and an incision is made usually behind the hairline. A good cosmetic result is achieved after the surgery and a hair sparing technique, which requires shaving only one-fourth inch-wide area along the incision proposed is aimed. At times, the total area of the incision may be shaved.
  • The skin and muscles are then removed from the bone and folded back, burr holes are made in the skull using a drill.
  • A saw is introduced through the holes made and cuts the bone flap’s outline. The protective covering of the brain named dura is exposed after the craniotome (the saw) removes the bone flap. This bone flap is kept aside securely to be attached back again after the surgery.
  • Once the dura is opened with surgical scissors, the surgeon folds it back to access the brain. There are retractors placed on the brain to have a corridor opened gently in the brain to address the region requiring removal or repair. 
  • Loupes are used by neurosurgeons, which are special magnifying glasses or an operating microscope to get a view of the delicate nerves and vessels.
  • The brain is very tightly enclosed within the skull and hence, removal of tissues cannot be done easily to repair problems.
  • Therefore, a variety of tools and instruments are employed to work in the deep circuits of the brain like drills, lasers, ultrasonic aspirators (used to break tumours and have the pieces suctioned), dissectors, long handled scissors, and of course computer-aided guidance.
  • Evoked potential monitoring may also be employed to stimulate the specific cranial nerves and the responses generated are monitored. This step ensures that the nerves are functioning properly and not getting damaged as a result of the surgery.
  • After the problem is rectified, the retractors are released and dura is closed along with sutures and the bone flap is placed in its original position and secured with titanium screws and plates. These screws and plates remain permanently in place to support the region and can be felt under the skin.
  • A drain can also be kept as is for some time. It helps collect blood and fluids from the area that is subjected to the surgery. T
  • he skin and muscles are sutured together and a soft turban-like adhesive is placed as dressing over the incision.

Recovery from Craniotomy

  • The patient is shifted to a recovery room where vital signs are monitored after he or she is in complete senses and the effect of the anaesthesia completely wears off.
  • Drowsiness, nausea, and headache are common in craniotomy recovery surgery. Hands, fingers, and toes must be moved frequently to avoid the formation of blood clots.
  • Anticonvulsant medications may be provided and a nurse may keep asking simple questions to figure out alertness.
  • Hospital stay varies from two to three days or even two weeks, depending on the complications that may result.
  • After discharge, keep away from strenuous activities. Some exercises may be prescribed for the slow movement of head and neck.
  • You should notify your doctor about any increase in temperature or infection observed at the sites of the incision. Bathing instructions should be strictly followed.
  • It almost takes around two to eight weeks for complete recovery. Keep visiting your doctor for follow-up checkup or as instructed. Contact your doctor immediately in case of loss of mental function, stroke, seizure, or nerve damage.

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Frequently Asked Questions

What is the health care infrastructure of the United Arab Emirates / Why should opt for the United Arab Emirates as a destination for your medical treatment?
The United Arab Emirates is counted among the most developed countries in the world in terms of healthcare benefits. UAE is home to some of the most progressed states and cities in the world which are praised for embracing modern advancements with open arms. Apart from the various other developments, the healthcare benefits, including the professionals and the infrastructure, are astounding. In contrast to the other major countries, the United Arab Emirates, however, does not charge an exorbitant fee in return for necessary treatment, which is why thousands of people opt UAE as their primary medical treatment destination. Besides, it is well-connected to various corners of the world which also makes it easily accessible by candidates all around.
What are the conditions of the hospitals in the United Arab Emirates? Are they JCI certified? What is the quality of the support staff in the hospitals?
The hospitals in the United Arab Emirates are known for providing exemplary services to the visitors. A high number of these hospitals and clinics are known for their incomparable patient interaction as well as infrastructure. The hospitals are very well-maintained and thus, pose least threat to survival. A large number of hospitals are known to be JCI approved as they have accomplished every infrastructural requisites as well as maintained a healthy medical environment to serve international tourists for healthcare purposes. Though there are several JCI approved hospitals in UAE, here are five popular ones among them:
  • American Hospital Dubai
  • International Modern Hospital
  • Dubai Hospital- DOHMS
  • Rashid Hospital- DOHMS
  • Oasis Hospital
One of the primary reasons for the hospitals bagging JCI accreditation is the quality of staffs working there. Not only the doctors and the surgeons serving patients, but also the support staffs are well-rounded to handle all kinds of situations to ensure quality support required by the candidates.
Are the doctors/surgeons in the United Arab Emirates of the best quality?
The doctors and surgeons in the United Arab Emirates are globally recognized for their service towards the medical field. Furnished with degrees from reputed universities and decades of training and experience, the doctors have earned high success rates throughout their professional career.
What is the process for obtaining a medical visa in the United Arab Emirates?
Certain countries allow visitors to enjoy visa-free entry for a period of 30 days, 90 days or 180 days, varying upon the country and the rules followed. In the UAE, the Patient Companion Visa and the UAE Medical Treatment Visa might be required, depending on the period of staying for medical purposes. Although the visas are arranged by the hospitals (in most cases) where treatment in being availed, yet the candidate must posses the following documents necessary for travelling and availing medical benefits from UAE:
  • Two passport size pictures of the candidate not older than six months
  • Valid passport (original and photocopy) which should not have expiration at least 6 months beyond the stipulated stay of the candidate
  • Valid proof of medical insurance showing the financial credibility
  • Medical certificate issued by the registered medical practitioner treating the candidate, clearly stating the requirement and the cause of the travel.
  • Acceptance letter from the medical practitioner to whom the candidate is being referred to.
What support services does MediGence provide in the United Arab Emirates?
Candidates availing treatment in a different country goes through high speculations. Besides the urgency and the immediate need for treatment, there are several other hassles, dealing which becomes tough for the individuals. Keeping in mind such dilemma, MediGence takes complete responsibility and provides umpteenth care so as to relieve the candidate from unnecessary exhaustion. Thus, the services provided are:
  • On-Ground Support
  • Teleconsultations
  • Visa Assistance
  • Accommodations Assistance
  • Free Airport to Hospital Transfer
  • Rehabilitation and recovery services
Which are the best cities in the United Arab Emirates for medical treatment?
The United Arab Emirates is known for housing some of the most advanced metropolises in the world. However, among them only a handful are renowned for the medical treatment facilities offered. Hence, some of the best cities for medical treatment in the United Arab Emirates are:
  • Dubai
  • Abu Dhabi
  • Sheikh
  • Sharjah

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