Dizziness After Craniotomy: Causes And Management

Dizziness following a craniotomy is a relatively common postoperative symptom. It can be attributed to various factors, including the effects of general anesthesia or the surgical procedure itself. During a craniotomy, significant fluctuations in intracranial pressure (ICP) may occur, which can lead to dizziness. For example, postoperative brain swelling or bleeding may elevate ICP, resulting in dizziness. Conversely, excessive loss of cerebrospinal fluid during surgery can cause a drop in ICP, also contributing to dizziness.

Potential Causes Of Post-Craniotomy Dizziness

One of the key reasons for dizziness after brain surgery is the impact on neural structures. In procedures involving the posterior fossa, such as tumor removal, retraction of the cerebellum or damage to the vestibular nerve can lead to significant postoperative dizziness. Additionally, post-surgical swelling in the brain tissue can exert pressure on sensitive areas, further contributing to balance disturbances and vertigo-like symptoms.

How Surgical Approach Influences Dizziness

The type of craniotomy performed—whether supratentorial or infratentorial—can influence the likelihood and severity of dizziness. Surgeons must also consider the extent of manipulation involved, the presence of brain edema, and the overall recovery trajectory when evaluating a patient's symptoms. Each of these variables can affect the central nervous system's adaptation and recovery, thus influencing postoperative balance and spatial orientation.

Treatment Options Based On Underlying Cause

Managing post-craniotomy dizziness depends largely on identifying its underlying cause. If elevated ICP is responsible, medical therapy with osmotic diuretics such as mannitol may be prescribed to reduce swelling and alleviate symptoms. In contrast, if dizziness stems from low ICP due to CSF leakage, conservative measures such as bed rest in a supine position and intravenous fluid administration are typically recommended to restore normal pressure and improve symptoms.