Read about what will happen in the first few hours and days after your operation and how you’ll feel.
Waking up after your operation
Most people wake up fairly quickly after brain surgery. But in a few situations, your surgeon might decide to keep you asleep for a few days more, to help you recover. They use sedatives to keep you asleep.
While you are asleep you might be on a breathing machine (ventilator). This can be frightening for those who visit. Your surgeon will talk through what is going to happen if this applies to you. They go through things with you and your family so that you can prepare as much as possible.
When you wake up after your operation
After a big operation, you wake up in the intensive care unit or a high dependency recovery unit. You usually move back to the ward within a day or so.
In intensive care you have one to one nursing care. In the high dependency unit you have very close nursing care. Your surgeon and anaesthetist also keep an eye on your progress.
These units are busy and often noisy places that some people find strange and disorientating. You'll feel drowsy because of the anaesthetic and painkillers.
Observations and checks
Your nurse will be taking your neurological observations. These are the same tests you had before your operation. For example, the nurse will check how alert you are. And shine a light into your eyes to check that your pupils react.
You have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse and oxygen levels (called a pulse oximeter).
Your nurse will check your blood pressure and neurological observations every 15 minutes when you first come round.
When you wake up, you might have a dressing over your wound site. This is usually left alone for about 5 days. Stitches or surgical clips can usually come out between 5 to 14 days after surgery. Some surgeons use stitches that slowly dissolve by themselves and so you don't have these removed.
You might also have a tube to drain fluid, which your nurse will take out about 24 hours after your operation.
If your head was shaved when you went to theatre, it may be a shock when you first see yourself. Your hair will grow back but the speed at which it grows can vary between people. Your head may be itchy at first, but try not to scratch too close to your wound.
Your jaw might be stiff and painful if your operation was near your temple (between the side of your eye and your hairline). This might last a few days or weeks after surgery. You may find it difficult to open your jaw. This is because the surgeon had to move or cut the muscles of the jaw. The stiffness gets better by itself in a short time. Making chewing movements or chewing gum helps.
You might find that your forehead or face are swollen. This swelling will go down over time, this could take some days or longer for some people.
Tubes and drains
When you are fully awake, you notice that you have several different tubes in place. You might also have an oxygen mask on for a while.
All the tubes can be a bit frightening. But it might help to know what all the tubes are for. You might have:
- drips (IVs – intravenous infusions) to give you medicines, blood transfusions, and fluids until you are eating and drinking again
- a tube into an artery in your wrist or ankle for taking blood samples and accurately measuring your blood pressure
- one or more drains coming out of your wound (connected to bags or bottles) to drain blood and tissue fluid from the operation site
- a tube into your bladder (urinary catheter) so that your urine output can be measured
- a tube down your nose into your stomach (nasogastric tube) to stop you from being sick
Among the tubes coming out of your head bandages, there may be a drain called an external ventricular drain (EVD). This drains excess fluid from the brain to stop the fluid building up (hydrocephalus).
You might also have an intracranial pressure (ICP) monitor. A tube from your head is connected to a machine. This measures the pressure inside your head. It will be taken out after a day or so.
Your nurse will measure your urine output because this helps to show whether you have too much fluid in your body or too little. Too little fluid means that you are dehydrated. Keeping your fluid balance right helps to stop swelling around the operation site in the brain.
You might have a headache when you wake up. You will have painkillers to help control this. Your surgeon might not want you to have very strong painkillers because they could cover up important symptoms.
It is unusual to get a lot of pain after a brain operation. You might have more pain if you have had surgery on your spine. If so, you might have painkillers through a drip into your vein. Do say if you feel your painkillers are not controlling the pain. Your nurse can adjust the dose if necessary.
A worsening headache might be a sign of swelling inside your skull. You may need treatment with steroids to help control it.
Other drugs after surgery
Surgery can cause swelling. This increases the pressure in your skull and make symptoms worse for a short time.
You might need to have steroids after surgery, either as tablets or injections. Steroids can reduce swelling and pressure around the brain, and so can reduce symptoms.
After surgery. your surgeon will tell you how to slowly reduce your steroids. You might eventually stop taking them completely. There is no fixed treatment time for steroids, it varies from person to person.
Anti epileptic drugs
It is common to take medicine to prevent fits (seizures). These are called anti epileptics or anti convulsants. Fits (seizures) can be a symptom of raised pressure in your skull. They might also be caused by irritation of the nerve cells of the brain.
You may be able to stop taking these medicines once you have fully recovered from surgery. But some people need to take medicines long term.
Eating and drinking
You might have a tube down your nose at first. This is called a nasogastric tube. It attaches to a drainage bag. It is there to stop you from being sick. Being sick is a strain and might raise the pressure inside your head.
As soon as you are fully awake, your nurse will give you a few sips of water. They watch carefully to make sure you don't have any problems swallowing. This can sometimes happen after brain surgery. Your swallowing may be checked by a speech and language therapist before you are allowed anything to eat or drink.
Once you can manage sips of water without feeling or being sick, your nurse takes out the nasogastric tube. Gradually you can build up to having normal meals again.
For the first few days your nurses will help you to avoid straining to do anything. Straining might raise the pressure in your head.
Depending on the operation you have, you might need to lie flat for a few days. Or you might have the head of your bed raised to reduce swelling in the brain. Your nurse will encourage you to move your arms and legs whilst you are in bed. They will regularly move you from side to side.
When you are awake, your nurse will remind you to take deep breaths every hour. It is important to try to avoid coughing, becase this can increase the pressure in your head.
Getting up and moving around might seem very difficult at first. But moving about helps you to get better and also reduces the risk of blood clots in the legs.
Your nurses will encourage you to get out of bed and sit in a chair as soon as your surgeon says you are able. When you first start walking, you might need to have someone with you.
You might see a physiotherapist, who can help with moving and breathing exercises.
Brain scans after surgery
About 48 to 72 hours after surgery you might have a brain scan. A CT scan or MRI scan can show if there is any tumour left and how much swelling there is in the operation area. It might be uncomfortable having a scan so soon. But this may be the best time for your surgeon to get a detailed picture of the operation site.
You’ll have follow up appointments to check your recovery and sort out any problems. This is your opportunity to raise any concerns you have about your progress.