A craniotomy is the surgical removal of part of the bone from the skull to expose the brain. Specialized tools are used to remove the section of bone called the bone flap. The bone flap is temporarily removed, then replaced after the brain surgery has been done.
Some craniotomy procedures may use the guidance of computers and imaging (magnetic resonance imaging [MRI] or computerized tomography [CT] scans) to reach the precise location within the brain that is to be treated. This technique requires the use of a frame placed onto the skull or a frameless system using superficially placed markers or landmarks on the scalp. When either of these imaging procedures is used along with the craniotomy procedure, it is called stereotactic craniotomy.
Scans made of the brain, in conjunction with these computers and localizing frames, provide a three-dimensional image, for example, of a tumor within the brain. It is useful in making the distinction between tumor tissue and healthy tissue and reaching the precise location of the abnormal tissue.
Other uses include stereotactic biopsy of the brain (a needle is guided into an abnormal area so that a piece of tissue may be removed for exam under a microscope), stereotactic aspiration (removal of fluid from abscesses, hematomas, or cysts), and stereotactic radiosurgery (such as gamma knife radiosurgery).
An endoscopic craniotomy is another type of craniotomy that involves the insertion of a lighted scope with a camera into the brain through a small incision in the skull.
Aneurysm clipping is another surgical procedure which may require a craniotomy. A cerebral aneurysm (also called an intracranial aneurysm or brain aneurysm) is a bulging weakened area in the wall of an artery in the brain, resulting in an abnormal widening or ballooning. Because of the weakened area in the artery wall, there is a risk for rupture (bursting) of the aneurysm. Placement of a metal clip across the “neck” of the aneurysm isolates the aneurysm from the rest of the circulatory system by blocking blood flow, thereby preventing rupture.
Craniectomy is a similar procedure during which a portion of the skull is permanently removed or replaced later during a second surgery after the swelling has gone down. .
Other related procedures that may be used to diagnose brain disorders include cerebral arteriogram , computed tomography (CT) scan of the brain , electroencephalogram (EEG) , magnetic resonance imaging (MRI) of the brain , positron emission tomography (PET) scan , and X-rays of the skull . Please see these procedures for additional information.
Extended Bifrontal Craniotomy: This procedure is performed to operate meningiomas, esthesioneuroblastomas, malignant skull base tumors, and tumors that cannot be removed by a minimally invasive approach. In this process, the frontal bone of the skull has been cut briefly so the tumor could be removed with no manipulation of the mind.
Supra-Orbital Craniotomy: It is also known as the “eyebrow” craniotomy, the supraorbital craniotomy is a least nosy procedure in which a small laceration is made within the eyebrow to remove pituitary tumors or tumors that are located in front of the brain. This technique is done while the tumor is too big to get an endonasal endoscopic operation.
Orbitozygomatic Craniotomy: This is performed to remove difficult tumors and treat aneurysms. It’s done by temporarily taking away the bone which forms the shape of this clitoris and orbit. Craniopharyngiomas, adrenal glands, and meningiomas are treated for this method.
Translabyrinthine Craniotomy: In this procedure of craniotomy, the incision is made just behind the ear. Thereby the mastoid bone and a number of the internal ear bone have been removed to extract the tumor without causing any injury to the mind. Acoustic neuroma is treated within this surgical procedure although its only drawback is the loss of hearing.
A craniotomy Surgery may be done for a variety of reasons, including, but not limited to, the following:
As with any surgical procedure, complications may occur. Brain surgery risk is tied to the specific location in the brain that the operation will affect. For example, if the area of the brain that controls speech is operated on, then speech may be affected. Some more general complications include, but are not limited to, the following:
To prepare for the surgery, you’ll have one or more preoperative appointments with your neurosurgeon.
They’ll use various tests to confirm you can safely undergo the procedure. This will likely include:
Your surgeon will also determine the surgical site based on your medical condition and type of craniotomy.
On the night before your surgery, you’ll fast (not eat) after midnight. You might also need to wash your hair with antiseptic shampoo.
Depending on your condition, your surgeon may have you take other steps to prepare.
When you arrive for the surgery, you’ll remove all of your clothing and jewelry. You’ll wear a hospital gown.
You’ll sit or lie down on the operating table. The position depends on the part of your brain being operated on. A head device will hold your head in place.
Next, your healthcare team will:
Your surgeon will make an incision on your scalp. They’ll use a medical drill and saw to remove a piece of bone called a bone flap.
Next, your surgeon will cut the dura mater to access the brain. The dura mater is the brain’s outermost membrane.
Your surgeon will perform the procedure and remove tissue samples, if necessary.
When the procedure is done, they’ll stitch the tissue back together. They’ll replace the bone flap with wires, stitches, or plates.
Finally, your surgeon will stitch or staple the skin incision, then apply a sterile bandage.
The procedure can take approximately 2 1/2 hours.
Recovery from a craniotomy will depend on the type of procedure you have had. Often, a 3-7 day hospital stay is needed. A temporary urinary catheter may be draining your urine after the surgery.
You will be told how to care for your surgical incisions and will be given any other instructions before leaving the hospital.
Your medical team will teach you about the medications you will be taking, such as those for pain, blood clot, infection, constipation, and seizure prevention and/or other conditions.
Contact your healthcare team with any of the following symptoms:
A. A craniotomy is a brain surgery that involves the temporary removal of bone from the skull to make repairs in the brain. It is highly intensive and comes with certain risks, which make it a serious surgery.
A. A follow-up appointment is made 10 to 14 days after surgery. The recovery time varies from 1 to 4 weeks depending on the underlying disease being treated and your general health. Full recovery may take up to 8 weeks. Walking is a good way to begin increasing your activity level
A. Craniectomies have a high chance of success. One study suggests that most people who have this procedure because of a severe traumatic brain injury (STBI) recover despite having to face some long-term complications.