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Types and Procedures of Blood Clot Brain Surgery
Before understanding the different types of brain clot surgery along with their respective procedures, it is important to know the types of haematomas that can be observed near the brain area:
Epidural Haematomas: This generally occurs due to an injury caused to the middle meningeal artery located often near the temple. The bleeding gathers in the epidural space which is present outside the brain’s lining or “dura”. As the dura is attached to the skull, even small haematomas can result in significant amount of pressure.
Subdural Haematomas: The source of this category is also injury, but it is mainly located in the veins present inside the brain. The leak of blood will be lower than that in other categories which gradually enters the “subdural” space present below the dura.
Intracerebral Haematomas: These haematomas are seen inside the brain tissue itself. This may result from bleeding caused due to uncontrolled high pressure, trauma, stroke, tumour, or an aneurysm rupture or leak.
For treating a haematoma occurring in the brain, surgery will be necessary. The type of haematoma you have will determine the choice of surgery the surgeon will opt. There are two major types.
Procedure Involved in Burr Hole Drainage
In this surgical procedure, the clot located near the brain is removed. These clots are also known as subdural haematomas as they occur below the dura. As haematomas can compress the brain tissue, it can bring about many life-threatening complications. Some cases may require an open surgery, but for some will need a burr hole drainage. Here, a small percolation is formed through the patient’s skull to let out the blood by sucking it out for relieving the pressure created on the brain.
In patients having chronic subdural haematoma, the clot may start to expand gradually with time without showing evident symptoms initially. Some of the risk factors that increase the chances of having subdural haematoma include using anticoagulant medications, older age, excessive consumption of alcohol, and brain injuries.
For conducting this procedure, general anaesthesia will be necessary. The head of the patient will be shaved where the treatment will be conducted. After positioning the head accurately, the surgical team will apply an antibiotic solution to prevent any form of infection. A small incision will be made through the scalp and with the help of a surgical drill; a small percolation will be made. The durawill be cut opened and get access to the haematoma. The area will be rinsed out through irrigation. The region will be then drained using a tube to make sure that the blood clot along with extra fluid is drawn out. The incision will be closed after that.
Procedure Involved in Craniotomy
When the haematoma is more severe and large, an open surgery will be necessary. This procedure is called craniotomy. This surgical approach is considered to be more effective as compared to the other treatment method when the haematomas that are causing troubles are not improving by themselves. In this procedure, the skull of the patient is opened up for removing the blood clot that formed earlier. An incision is necessary to be made in the scalp, after which a bone termed as the bone flap is removed for accessing the location that has been affected by the blood clot. The haematoma will be removed by the surgeon and the site will be drained without causing any damage to the nearby tissue. After the blood clot is removed, the opening of the skull will be replaced and reattached with the bone flap. Following that, the scalp tissue will be sutured.
Diagnosis for Blood Clot Brain Surgery
An in-depth analysis if the veins, skull, brain, and other blood vessels are necessary for diagnosing the condition. Diagnosing can be slightly difficult in case of haematomas in the brain as it may not appear physically. After the head injury, there are chances of losing the consciousness progressively.
Imaging techniques are applied for discovering the presence of haematomas in the brain area. The techniques used are:
CT Scan: Here, a sophisticated X-ray machine is using after linking with a computer to form detailed images of the brain. The patient will be lying on a movable table that will be taken into a machine that appears like a doughnut for the images to be taken. It is one of the most commonly used techniques for diagnosing haematomas in the brain.
MRI Scan: In this technique, a large magnet along with radio waves is used for making computerized images. The patient will be guided to a tube on a movable table. MRI scans are not as readily used as CT scans for diagnosing haematomas as MRI scans require a longer duration for performing.
Angiogram: If there might be a chance of the presence of aneurysms in any blood vessel of the brain, an angiogram can be used for diagnosing the condition. In this test X-rays along with a special dye is used for producing pictures of the flow of blood in the blood vessels.