Diet taboos after craniotomy

Within 3 months after surgery, priority should be given to avoiding alcohol, caffeinated drinks, high-salt, high-fat and spicy foods. Patients with epilepsy risks should also avoid foods with high histamine levels that can easily induce nervous excitement. The remaining taboos can be flexibly adjusted according to individual recovery conditions.

I have been doing follow-up work in neurosurgery for almost 6 years, and I have seen too many patients who have fallen into trouble due to diet. I really don’t believe in evil. Last year, there was a 32-year-old young man who had a brain hemorrhage surgery. He was recovering very well. He could walk and talk without any sequelae. On the second day after he was discharged from the hospital, a friend made an appointment with him for coffee. He thought that he would be fine. He would be fine if he drank half a cup of iced Americano. However, within 2 hours after drinking it, he had a headache and became nauseous. When he came back for a follow-up CT scan, he found that the edema around the surgical area had reappeared. The intracranial pressure was nearly 20mmH₂O higher than when he was discharged. He took dehydration medicine for another three days before he recovered.

Why are caffeine and alcohol the number one no-no? In fact, the essence is that both of these will expand cerebral blood vessels. After craniotomy, the blood-brain barrier in the brain has not been completely repaired, and the stability of blood vessels is also poor. Once expanded, it is easy to aggravate edema and even induce bleeding in unhealed wounds. Regarding the contraindication duration of caffeine, different centers do have different requirements. Most of the top domestic neurosurgery centers require no caffeine at all for at least 3 months. Some European guidelines also state that if you have no risk of epilepsy and the edema has completely disappeared after surgery, it is okay to drink a small amount of decaffeinated coffee after 1 month. Just follow your doctor's instructions and there is no need to impose strict standards.

Many family members always feel that they need a lot of supplements after surgery. This is really the hardest hit area. There used to be a 60-year-old aunt who had a glioma surgery. Her children were filial, and she stewed pork elbows in sauce, pickled fish, and added a lot of ginseng and astragalus every day. When she was discharged from the hospital, her edema was almost gone. When she came back for a follow-up examination half a month later, the CT scan showed that there was new edema around the surgical area, and her blood pressure soared to 150/90. After asking, I found out that the amount of salt my aunt eats every day is almost twice that of normal people. High salt will aggravate water and sodium retention. The blood vessels in the skull are already fragile. If the excess water runs around the surgical area, won't it cause swelling? As for those blood-activating tonics, be careful not to take them indiscriminately in the first two weeks after the operation. I have seen one of the most dangerous patients. On the 5th day after the operation, his family secretly fed him half a bowl of ginseng and black-bone chicken soup. The drainage fluid turned from light pink to bright red that night, and he almost had to have a second craniotomy to stop the bleeding. It was really a good intention but a bad thing.

There is another topic that has been debated for decades, which is whether we should avoid "hair growth" after craniotomy? Many Western medicine doctors will say that you can eat it as long as you are not allergic, while traditional Chinese medicine will tell you not to touch mutton, seafood, and rooster. Among the cases I have been exposed to, there are indeed several patients who need to take anti-epileptic drugs after surgery. After eating more than a pound of braised mutton or iced seafood at one time, they induced epileptic seizures. Later, after checking relevant research, I learned that in fact, most of these foods are high in histamine, which may indeed affect the stability of neurotransmitters. Therefore, the current more compromise view in the industry is: If you have no history of epilepsy after surgery, and have not taken anti-epileptic drugs, and you have not been allergic to these foods before, it is perfectly fine to eat them normally. ； But if you had epilepsy before surgery, or the doctor prescribed anti-epileptic drugs to prevent seizures, try not to eat a large amount of these high-histamine foods in the first three months, and don't dare to touch even one bite. Tasting a few bites will not be a big problem to satisfy your cravings.

Oh, by the way, there are also functional drinks that are said to be "brain-enhancing" and milk tea with extremely high sugar content. Try to avoid them as much as possible, especially for patients with unstable blood sugar after surgery. High sugar will increase the burden of brain metabolism. If you drink it and suffer from insomnia, it will have a greater impact on brain recovery than eating two wrong bites.

In fact, in the final analysis, there are really not so many black and white rules for post-operative diet. I have seen patients who recovered quickly and ate a small amount of light hot pot one month after the operation, and I have also seen patients who had strict dietary restrictions for half a year and still had problems. The key point is to see your own recovery. If you are really craving for a certain bite, send a message first and ask your surgeon. He knows your surgery and physical condition best. He will say that it is better to try something when you can than to be afraid after eating it secretly. After all, craniotomy is not a minor surgery, so it is always right to be more careful.