Emergency Skull Opening For Stroke

Table of Contents

I have and will always hail the amazing brain , everything in this world is to do with the brain. The human brain is very soft , its not as hard as ghee , but should be near vaseline in consistency.

Owing to its importance ,and very fragile nature , the brain is kept in a very hard and rigid container of bones called the skull , making it the most protected body organ in the universe 

A Fresh Human Brain , Appreciate How Soft It Actually Looks!

How Does The Body Respond To Injury ?

It really hurts to be insulted , even verbally , mood changes , we get annoyed , heart races faster , we yell , insult or fight back!

Have you noticed that any body part swells whenever there is injury ? , the magnitude of injury determines how bad the swelling gets.

An Insulted Eye Had To  Swell
Swollen Abdomen , Obviously There Is An Underlying Insult.

Simply put , whatever is injured swells !

Brain Response To  Injury (Stroke )

Stroke occurs when a blood vessel in the brain is occluded or narrowed  interfering with blood flow to the brain, thus brain injury.

A Blood Clot In Brain Blood Vessel , Commonest Cause Of Stroke

Stroke may also be due to a ruptured blood vessel in the brain, causing bleeding into the brain.

Schematic Diagram Of Stroke Due To Brain Bleeding ( Red Is The Bleed 🩸)

Stroke patients  have brain damage / injury / insult , we have already agreed that whatever is injured swells , the brain is not an exception.

One must and should  understand that this very fragile brain is stored in hard rigid container ( skull bones ) , so if it must swell after a bad stroke , it needs space !

That is why it is important to understand that some ( definitely not all) stroke patients need emergency removal of part of the very rigid skull bones to give space for the brain to peacefully swell.  

Having the skull of a loved one opened is not a casual matter , but  allowing a very soft brain to swell in a non-open rigid skull  only adds insult to injury.

Real Life Scenario

Apologies in advance , let us look at the brain CT scans of this quadragenarian , story was “ found unconscious in the bathroom ”  , if you are curious why always the bathroom , so am i.

Red Circle is area of brain bleeding , the white inside red circle  is actually fresh blood inside the brain

Big insult , Big stroke , we certainly need (not want)  space for the brain to safely swell.

Skull Bones Are The White Circle , But Part Of The Circle Is Missing Because That Bone Was Taken Off To give The Brain Swelling Space, Yellow Showcases The Edges Of The Removed Bone.
See How Swollen The Brain Is ( Red)
You Don’t Need Guts To Appreciate That The Brain Is Swelling Beyond The Confines Of The Skull ( Blue)

The damage here was extensive , patient did not make it , but is atleast raising awareness on the  role of emergency skull opening in stroke , this much urgently needed surgery is what experts call “ decompressive craniectomy for stroke “.

At times , emergency skull opening tops a stroke patient’s needs , delaying or denying them one only fans the flames.

Some patients actually do well after emergency skull opening , the removed skull bone is safely stored in the abdomen (tummy) in most cases , that way  we won’t lose this much later needed spare part ( removed skull bone). When the dust settles , the removed skull bone is placed back , something called cranioplasty.

The term cranioplasty actually should not cause any un-neccesary confusion  , as cranioplasty = cranio + plasty ;

Cranio = Short form of cranium , with means skull.

Plasty = Repairing

So simply put  cranioplasty is skull defect repairing , show-cased in the  3D picture of the skull below.

For those having trouble , yellow shows you the margins of the replaced skull bone.

Should you or the loved one ever be advised to under go emergency skull opening , do not delay to consent to one , stroke is a race against time.

Just like life , for stroke , we can only do what we have to do , timely – i must add.

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