What exactly happens before, during and after a Craniotomy?

Mary: Quite an array of responses. I guess I will add my own. I had my procedure done at the University of Calif. in San Francisco. About 3 weeks before my surgery a Nurse Practitioner called and asked some questions and told me I needed to get blood work done within a 2 week window of my surgery. After my blood work was posted a nurse in the anesthesia department called and asked more questions. After this phone consult with the anesthesia nurse she said, "Ok, I'm going to approve that we go ahead with this surgery." Three days prior to surgery the anesthesiologist called and we had a 25 minute phone consult. Next, I had to travel to San Francisco (90 minute drive if no commute traffic) for another MRI that had to be within 24 hours of the surgery. I was told arrive at the hospital the next morning at 6:30 for my 8 o'clock scheduled surgery and to shower at home beforehand. I was sent to pre-op for more blood work and the IVs put in that the medicine during the operation would be injected into. My anesthesiologist came in and once again asked more questions. Then, my neurosurgeon stopped by and the 3rd year resident who would be "assisting" (though I suspect after reading my reports he handled most of the craniotomy-but it's a teaching hospital so...) spoke with me at length to reassure me that they would not be aggressive in trying to remove the 2.7 meningioma 1/16th of an inch from my optic nerve. If they could scoop it out easily they would but in no way would they try to remove it at the expense of damaging my optic nerve. My conversation with this doctor really made a positive difference. After about 40 minutes it was time to be rolled into the surgery room and I had to say good-bye to my husband. My anesthesiologist and I had talked in pre-op about me getting something, like ativan, to kind of calm my nerves. She said I seemed to be doing fine. That she would give it to me if I wanted but it would prolong the time it would take for me to come out of the anesthesia after the surgery. So I didn't take it. In the future I would. The surgical suite was so cold, so bright, and what seemed for at least a half an hour all this noise of machines being moved around, more IVs inserted in my leg near my ankles, my husband not there, everyone very business like (well it was brain surgery they were getting ready for) and that was the most stressful part of my experience. Like I said, in the future I would take the ativan pre-surgery. The anesthesiologist never said, "Now we're going to put you to sleep." All of a sudden I was just out. My husband and 2 daughters got text messages every 20 minutes or so on how things were going. The surgery lasted just shy of 4 hours. I was told beforehand I would be in the intensive care unit but I was doing so well they put me in the "step down" unit which is a private room with a 1 to 3 nurse to patient ratio. My husband and the daughter without children took 12 hours shifts staying with me in the room with a mini-twin size bed for them. The second day I was walking to the bathroom myself. The 3rd day I went home. They said I didn't need to go to rehab. On discharge day the pharmacist with a PHD in pharmacology personally came to the room to go over all the medicines I would be taking at home. I think I was on keppra for seizures and steroids for inflammation for about 3 weeks to a month. Something like that. I was told to sleep at a 45 degree angle for a period of time, as they had me do while in the hospital. I did that for a week. You'll need one of those angled, wedge pillows. I slept a lot at home but felt fine. They had given me tylenol in the hospital round the clock but at home I think I took it once. I really didn't have any pain. Make sure you already have the stool softener at home before your surgery as it is really important you take this and not strain as that would increase the pressure in your head. My only set back was that my cranial nerve #4 was inflamed from the surgery and I had double vision for 3 1/2 months until it healed from the trauma. OK, Mary. I hope this wasn't T.M.I. I want to reiterate that the hysterectomy I had years ago was FAR worse regarding pain and just feeling horrible for 3 weeks. I was passing out Halloween candy 2 weeks after my craniotomy. My surgery was a year and a half ago when I was 70. Find a reputable hospital and a neurosurgeon you trust and I think you will be fine.

Thank you Colleen for answering my message. I'm still trying to understand how to reply/post here. Well my surgery was schedule for May 22, but I am having second thoughts. I really feel fine and so I am really worried about the side effects of this surgery. I was told back in June 2024 that this meningiomas grow really slow - but when I had the second one it has grown more than what I consider slow 2.7 to 3.1 cm. I don't have any symptoms (other than chronic headaches, that I have learned to live with). The neurosurgeon referred me to an oncologist, but he said that he recommends surgery, because radiation is only to kill cancer cells and that he doesn't really want to give me more radiation (since I have already been treated for the leukemia.) When I told the neurosurgeon about my doubts, he said we could wait another 6 months to get another mri and then from there decide on the surgery. So I think that is what I am going to do. I am going to keep getting and finding out as much info as I can on everything and then make a decision. Thank you again for taking the time to answer.

Thank you so much for all those who have responded to my questions. I have decided to wait, not because I don't need the surgery, but because I don't want to have this done right now --bottom line. And the reason is just that I am afraid, I am here in a small south Texas town, so if I am going to have this done, then I want to go somewhere else, maybe Houston.
The size of my meningioma is 3.1 x 3 x 2.1 cm
Cerebral Parenchyma: well-defined extra-axial T2 heterogeneously hyperintense and T1 isointense lesion in the right anterior frontal convexity. The lesion extends into the parafalcine location and abuts the superior sagittal sinus.
I have no idea what some of these words mean, but I am learning as much as I can everyday. I am glad I found this site and I have been able to find so many answers. The 1st doctor (neurologist) told me back in 6-2024, that these things grow really slow it was at 2.7 cm. So I decided to see a surgeon; I had the second mri in march and these were the results. He recommend a surgery, and at first I said yes, but once I found out the real procedures and all the side effects that can happen, than I decided to try a second opinion. He said I could consider radiation; but this last Monday, the oncologist said he would not do it because radiation is only done to kill cancer cells and that the best thing to do is surgery.

Both doctors said the fact that I do not have any serious symptoms and the location; then I can wait for the surgery. I really really don't want to wait for this to grow and then the surgery will be harder, but I just don't want to go thru this right now. I want to see if I can travel to Houston or San Antonio and maybe there have the surgery. Again thank you so much for your time and information and I will continue to look for your posts. Some of your answers make me feel at ease, and I know that I have to go thru this eventually so for now I hope I can find a good doctor soon.