Table of contents:
- When is stroke surgery necessary?
- What is hemicranectomia?
- Who can approve hemicranectomia surgery?
- How do you consider hemicranectomia surgery?
- Other types of stroke surgery
- Carotid endarterectomy
- Angioplasty
Often times, a stroke does not cause significant brain damage, so it can still be reversed with medication and therapy. However, some stroke cases cause severe bleeding that can have serious consequences. In certain conditions, stroke surgery needs to be done as soon as possible to prevent the risk of death.
When is stroke surgery necessary?
When a hemorrhagic stroke progresses, this condition affects the flow of blood through the main arteries in the middle cerebral. Almost all parts of the brain are completely deprived of blood, causing rapid death and bleeding in nearly half of the brain.
Because the brain is encased in the walls of the skull bones, this bleeding causes an increase in intracranial pressure (ICP) which results in enlargement of the damaged area of the brain.
In the end, the increase in intracranial pressure will prevent blood from flowing to the part of the brain which results in the rapid death of brain cells. In most cases, the best way to relieve intracranial pressure is through a stroke operation called hemicranectomia.
What is hemicranectomia?
Hemicranectomia is an effective procedure to reduce the rate of cerebral hemorrhage.
This surgical stroke procedure is performed under the use of anesthesia, removing part of the skull frame to allow the brain to bleed beyond the cranial boundary without causing a further increase in brain pressure.
The part of the skull that is removed is usually frozen until the bleeding subsides, and then the skull can be replaced.
Does every major stroke have to go through a hemicranectomia procedure? Not.
Indeed, many doctors recommend this in cases of severe brain hemorrhage due to hemorrhagic stroke. However, many other doctors also think that even though the benefits of stroke surgery with hemicranectomia do not guarantee the quality of life for postoperative patients will be better.
This usually occurs in a hemorrhagic stroke that causes large bleeding, for people who are medically weak, as well as elderly sufferers. Thus, much controversy surrounds the impact of this procedure on the lives of patients and their families.
Who can approve hemicranectomia surgery?
The decision whether a patient should undergo hemicranectomy can only be made after consideration and consent from the family.
Therefore, the opinion and consent of the family is as important as that of the medical team, except when a stroke operation is performed in very precarious circumstances.
Fortunately, many families know what the patient wants before having a stroke through conversation.
For example, the patient may have spoken to his parents or siblings about wanting to let him go in peace if he has a serious brain injury or is about to become disabled for life. In such cases, it is wise to respect the wishes of the patient.
How do you consider hemicranectomia surgery?
If you are faced with the fact that someone closest to you has to undergo hemicranectomy stroke surgery, the following questions may help.
- What is the likelihood that your loved one's brain will be functioning again after undergoing a hemicranectomy?
- If the surgery is done and she survives a stroke, will she have a chance to eat or breathe? If not, has she shared her feelings about using a feeding tube or mechanical ventilation?
- Has your loved one ever expressed what they would like to face in this situation?
Other types of stroke surgery
Treatment of stroke through surgery can not only repair the damage, but also help prevent future problems.
In some cases of minor strokes, for example, there are conditions in which mild stroke medications are no longer effective in preventing an actual stroke. The condition of the arteries is getting narrower so that it can trigger blockages in the near future. For this reason, the doctor will recommend that you undergo a stroke surgery procedure.
In people who are at risk of having a hemorrhagic stroke, the area likely to have a stroke must be close enough to the surface of the brain for the surgeon to have access to these blood vessels. If the surgeon can access the affected blood vessel, he can surgically remove it.
Stroke surgery like this can reduce the risk of a blood vessel rupture in the future. Some types of stroke surgery are performed to improve blood flow to the brain, including:
Carotid endarterectomy
Carotid endarterectomy is a stroke operation performed on patients with mild stroke symptoms. This means that a stroke occurs only temporarily.
However, surgery for stroke prevention can also be performed if other risk factors for stroke are known, such as cardiovascular disease, hypertension, and cholesterol.
In this procedure, the surgeon will remove plaque in the arteries that can potentially cause a stroke in the future.
In a study conducted by the Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada, this operation was effective at preventing stroke in 70 to 99 percent of preventing strokes in patients who had minor strokes due to narrowing of the carotid arteries.
Angioplasty
The narrowed carotid arteries can also be widened with an angioplasty procedure. This procedure is performed by attaching a catheter to the blood vessel in the groin area that carries a stenting device, such as a balloon, to the carotid artery.
After arriving at the carotid artery, the stenting device is then opened so that it expands the part of the blocked artery.
