The first week home after cranioplasty

Before you leave the hospital

Most people go home within a few days, once they can walk, shower and dress on their own.^1,2 Before you go, make sure you know:

• When and where your stitches or staples will be removed
• When your first follow-up visit is. Many teams see patients around 1 week, 1 month and 3 months after surgery.¹
• Which medicines to take, which to stop, and whether you can take over-the-counter pain relievers
• When you can shower and wash your hair
• Whether you still need to wear your protective helmet
• Who to call with questions, including after hours

Arrange for an adult to drive you home and, ideally, to stay with you for the first few days.

Caring for the incision

• Keep it clean and dry. Don't put creams, lotions or ointments on it unless your doctor tells you to.^4,5
• Don't scrub it. Wash gently when you're allowed to.⁵
• Look at it every day. Watch for leaking, more redness or swelling, or pain that is getting worse instead of better.³
• Stitches or staples come out in about 1 to 2 weeks. Hospitals give different windows, from 5 to 10 days at one to 10 to 14 days at another, and longer after a repeat operation through the same scar.^3,4,5
• Numbness or tingling around the scar is common and can last a few months.³

Showering and washing your hair

This is the instruction that varies most between hospitals, so ask your team directly.

• Most people can shower soon after surgery, as long as the incision is kept dry.^3,4
• Several hospitals say to wait until the stitches or staples are out before washing your hair, then use a mild shampoo.^3,4 Others allow gentle washing a few days after surgery.⁵
• Don't put your head under water, so no baths over the head, swimming or hot tubs, until you're cleared.⁵

A handheld shower head and a shower chair make this much easier while balance is still recovering. See the fall prevention checklist.

Headaches and medicines

• Headaches are common and can last from a few days to a few weeks.^3,5
• Take pain medicine exactly as prescribed.⁴
• Ask before taking aspirin, ibuprofen or similar medicines. Several hospitals tell patients to avoid them unless the surgeon approves.^4,5
• Watch for double doses of acetaminophen (Tylenol). Some prescription pain pills already contain it, so don't add over-the-counter Tylenol on top without checking.⁵
• Prevent constipation. Pain medicines often cause it, and straining should be avoided. Drink plenty of water, eat fiber and walk a little each day.^4,5
• Never stop seizure medicine on your own, even if you feel well.
• Skip alcohol while you're recovering and taking these medicines.⁴

Call your team if pain doesn't improve after taking your medicine.⁴

Swelling, bruising and sleep

• Swelling around the eyes and face is common and can last from a few days to about a week. Bruising can take one to two weeks to fade.⁵
• Sleep with your head raised, for example on two pillows or a wedge, to help swelling go down.^1,4,5

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Tiredness

Expect to feel worn out. One hospital tells patients to expect fatigue for one to three weeks, and says the brain takes roughly two to six weeks to heal.⁵ Rest often and keep visits short.

Sleeping more than usual is normal. Sleeping more than you're awake, or being hard to wake, is not. Call your team if that happens.⁴

Moving around and what to avoid

• Walk a little every day. One plan is 5 to 10 minutes, 2 to 4 times a day, adding a few minutes every few days.⁵
• Don't lift more than about 10 pounds for at least two weeks, or until your surgeon says otherwise.^4,5
• Avoid bending your head down below your waist.⁵
• No contact sports, biking or skateboarding until you're cleared.⁵
• Don't swim or hike alone, because of the risk of seizures.⁵
• Ask about your helmet. Don't stop wearing it until your surgeon says so. See the helmet guide.

Driving, work and travel

• Driving: don't drive until your doctor clears you, and never while taking prescription pain medicine.^2,5 Driving rules after brain surgery or seizures vary by state, so ask your team what applies to you.
• Flying: check with your surgeon before booking travel.⁵
• Work: this depends on how you feel and what your job involves. One hospital notes it is not unusual to be off for about six weeks.³ Overall recovery usually takes one to three months.¹

Warning signs

Call your surgeon's office right away for:

• A headache that keeps getting worse, or a headache with vomiting^3,4
• Fever, chills or a stiff neck^3,4,5
• Redness, warmth, swelling, pus or fluid leaking from the incision, or the incision opening^2,4,5
• New or worse weakness, numbness, speech or vision problems^3,5
• More drowsiness or confusion than before^3,5
• A fall where you hit your head⁴
• One-sided leg pain or swelling⁵

For caregivers

• Keep the discharge papers, medicine list and phone numbers in one place.
• Set up the home before discharge: a clear path to the bathroom, night lights, and a chair in the shower.
• Help with medicine times for the first few days. A weekly pill organizer makes this simpler.
• Check the incision with the patient each day and note any changes.
• Write down questions for the follow-up visit as they come up.
• Look after yourself too. The first week is tiring for caregivers as well.

Sources

1. Cleveland Clinic. Cranioplasty: what it is, procedure, recovery and risks. my.clevelandclinic.org/health/treatments/24924-cranioplasty
2. Johns Hopkins Medicine. Cranioplasty. hopkinsmedicine.org/health/treatment-tests-and-therapies/cranioplasty
3. University Hospital Southampton NHS Foundation Trust. After a craniotomy (patient information factsheet). uhs.nhs.uk (PDF)
4. UMass Memorial Health. Discharge instructions for craniotomy. ummhealth.org/health-library/discharge-instructions-for-craniotomy
5. UCLA Health Neurosurgery. Craniotomy patient discharge instructions. uclahealth.org (PDF)

Sources 3 to 5 are written for craniotomy, a closely related skull operation through the same kind of scalp incision. They are used here for general home-care advice; your own cranioplasty instructions take priority.