Care of the Client with Intracranial Surgery (Craniotomy)

A craniotomy might be performed on any client with a neurological disorder. The focus of care is early detection and prevention of any complications. If a client has a craniotomy, postoperative care is of particular importance. The following postoperative craniotomy interventions are important for you to know:

• Monitor vital signs and neurological assessments.

• Monitor cardiac rhythm.

• Perform passive range of motion exercises on the client.

• Assist the client to turn, cough, and deep breathe every two to three hours.

  Caution

  Be careful with coughing exercises because they can increase intracranial pressure.

  
  

• Use cold application for periorbital edema and bruising.

• Prevent deep vein thrombosis by compression stocking application.

• Position the client after surgery depending on which area of the brain was involved in the surgical procedure. Postoperatively, the client is positioned as follows:

• Supratentorial surgery (anterior and middle fossa): Elevate the head of the bed 30°.

• Infratentorial surgery (posterior fossa): Flat on either side. Use this position for one to two days after surgery.