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Dr Syed Abdullah Al-Haddad

Patient Guide · Brain Surgery

What happens during brain surgery?

Brain surgery, or craniotomy, is the subject of considerable anxiety for most patients — understandably. This guide explains the process in clear, straightforward terms, from the night before to the first days of recovery.

5 min read·Reviewed January 2025

What to expect

From admission to recovery

1

Before surgery

The evening before, you meet the anaesthetist who explains how you'll be put to sleep and kept comfortable. You'll be asked not to eat or drink for several hours before the procedure.

2

On the day

You're taken to the operating theatre. Once asleep under general anaesthesia, a small area of hair is shaved — kept as minimal as possible. The scalp is cleaned with antiseptic, and local anaesthetic is injected to reduce post-operative pain.

3

The procedure

An incision is made in the scalp. The skin and muscle are reflected, and small burr holes are drilled in the skull. A specialised saw connects these holes, and a piece of bone — called a bone flap — is lifted. This is the craniotomy. The operating microscope is brought in. Using this magnification, the tumour is removed. If it is near a critical area, intraoperative monitoring is used — stimulating the brain surface while a neurophysiologist observes for responses, mapping safe corridors.

4

Closing

Once the tumour has been removed, the bone flap is secured with small titanium plates. The muscle and skin are closed with sutures or staples, and a dressing is applied. You wake up in the recovery room.

5

After surgery

Most patients spend one night in the high-dependency unit for close observation, then move to the ward. You will be up and walking, with assistance, within 24 to 48 hours.

Most patients are up and walking within 24 to 48 hours — and the majority go home within a week.

What to remember

Key points about brain surgery

The brain itself has no pain receptors — you feel nothing during the operation
A small area of hair is shaved, and kept as minimal as possible
Intraoperative monitoring maps your brain's functions in real time to protect speech and movement
You'll be walking with assistance within 24 to 48 hours after surgery

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