After brain tumour surgery

You go to the recovery room after surgery. The nurses will monitor you closely while you are in the recovery room. Once it’s safe to do so, you go back to the ward. Some people might need to go to the intensive care unit (ICU) or the high dependency unit (HDU).

The information on this page covers what happens immediately after and the first few days after surgery for a brain or spinal cord tumour.

How long you stay in hospital depends on what operation you have. You will need to allow yourself time to recover when you get home.

Waking up after your operation

Most people wake up a few hours after their brain surgery. But sometimes, your surgeon might decide to keep you asleep for a few days after surgery, to help you recover. They use sedatives to keep you asleep.

While you are asleep, you might be breathing through a machine called ventilator. This can be frightening for those who come to visit you.

You are likely to feel drowsy and sleepy after you wake up. This is normal and it happens because of the anaesthetic and painkillers.

You, or your relatives, may also notice that your head or face are swollen and bruised. This swelling will go down over time. 

The intensive care unit or the high dependency unit

After the recovery room, most people go back to the ward. But some might need go to the intensive care unit (ICU) or the high dependency unit (HDU). You then move back to the ward within a day or so. How long you stay in the ICU or HDU is different for everyone.

In the ICU or HDU, you have very close nursing care. This is usually one to one (or two to one) nursing care. The nurses and doctors keep a very close eye on your progress. These units are clinical, busy and often noisy places. Some people find them strange and disorienting.

Observations and checks

When you first wake up, you usually have checks every 15 minutes.

Your nurse or doctor does checks called neurological observations (neuro obs) to check how alert you are. These are the same tests you had before the operation. Your nurse asks you questions and might shine a light into your eyes to see if the pupils react.

You have:

• a blood pressure cuff on your arm
• a clip on your finger called pulse oximetry to check your heart rate and oxygen levels
• sticky pads on your chest called ECG leads to monitor your heart

Your head

When you wake up, you will have a dressing over your wound and may have a bandage around your head. This is usually left alone for a few days. Your surgeon or specialist nurse can tell you more about this. 

Stitches or surgical clips can usually come out between 5 to 14 days after surgery. Some surgeons use stitches that slowly dissolve by themselves, so you don't need to have them removed.

If your head was shaved during the operation, 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. Try not to scratch too close to your wound.

Your jaw might be stiff and painful if your operation was between the side of your eye and hairline. This might last a few days or weeks after surgery. You may find it difficult to open your jaw wide. This is because the surgeon had to move or cut the muscles of your jaw. Making chewing movements can help with this.

Tubes and drains

You might notice that you have several tubes in place. This can be a bit frightening. It might help to know what all the tubes are for.

Not everyone has all of these tubes. The tubes you may have include:

Oxygen

You might have an oxygen mask over your mouth and nose. It gives you extra oxygen.

Drips

You might have drips to give you medicines, blood transfusions and fluids until you are eating and drinking normally. The drips are attached to a small tube called cannula in your hand or arm. Or they may be attached to a long line in your neck called central line.

A tube into an artery

You might have a tube into an artery in your arm. Doctors and nurses use this tube to take blood samples and accurately measure your blood pressure.  

Drains

You might have one or more tubes coming out of your wound. These are called drains and they connect to bags or bottles. They drain blood and tissue fluid from the operation site.

You may also have a tube coming out of your head bandage called external ventricular drain (EVD). This drains excess fluid from the brain and stops the fluid building up (hydrocephalus).

A tube into your bladder (urinary catheter)

This is so nurses can measure how much urine you are making. It helps the team make sure you are getting enough fluids.

A tube from the nose into your stomach (nasogastric tube)

The tube is taped to your nose and cheek. It is usually attached to a bag and can help with sickness.

An intracranial pressure (ICP) monitor

This is a tube from your head which is connected to a monitor. It measures the pressure inside your head. The ICP monitor is usually removed after a day or so.

Fluids

Having the right amount of fluids in your body is important, especially in the first few days after surgery. Too little fluids lead to dehydration. Keeping the fluid balance right helps to stop the swelling around the brain.

Your nurses will record how much you drink and how much urine you are making to make sure you have the right balance.  

Medicines you might take after brain surgery

Painkillers

You might have a headache when you wake up. You have painkillers to help control this. You have painkillers through the drip until you start eating and drinking again.

Your nurses and doctors will ask you whether you have pain. Tell them if you think the painkillers aren’t controlling the pain. They can adjust the dose if necessary.

Steroids

Surgery can cause swelling in the brain. This increases the pressure inside the skull and can make your 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. This can help to reduce symptoms. 

You might be able to stop taking steroids once you have fully recovered from surgery. Your doctor will tell you how to slowly reduce the steroids dose. There is no fixed treatment time for steroids, it varies from person to person. Some people need to carry on taking them for a long time.

Medicines to prevent seizures (anti epileptic drugs)

It is common to take medicine to prevent seizures (fits). These are called anti epileptics or anti convulsants. You might have them as tablets, liquids or injections.

Seizures can be a symptom of raised pressure inside the 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 them for longer. 

Eating and drinking

When 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. A speech and language therapist (SALT) may check your swallowing 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 if you have one. Gradually you can build up to have normal meals again.

A dietician might see you to make sure that you are getting the right amount of calories.

Getting up

Brain surgery is a big operation and you need to rest afterwards. For the first few days, your nurses will help you to avoid straining. Straining might raise the pressure inside your skull. 

Depending on your operation, 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 gently from side to side. This is to keep your muscles active and avoid blood clots from forming.

When you are fully awake, your nurse will ask you to take deep breaths every hour or so.

The team will help you to get out of bed and start moving as soon as it’s safe. This might seem very difficult at first. But moving helps you to get better quicker and reduces the risk of blood clots in your legs.

When you first start walking, you need to have someone with you. You usually see a physiotherapist, who can help with moving and breathing exercises.

Brain scans after surgery

About 2 or 3 days after surgery you might have a MRI scan or CT scan. A scan can show if there is any tumour left and how much swelling there is in the area of the operation. It might be uncomfortable to have a scan so soon. But research shows us this is the best time to get these images.

Recovering after brain surgery

It can take some time to recover from your surgery. You might want to read information about recovering after brain surgery next.