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What is a Craniotomy?

Removal of part of skull allowing surgeon to operate on brain and/or remove tumors, blood clots, etc.

A craniotomy is a surgical procedure that involves removal of a portion of the skull to access the tissues of the brain. This surgery is performed by a neurosurgeon while the patient is under anesthesia. We can perform a craniotomy on any part of the skull, depending on the location of the brain that needs to be accessed. The portion of the skull that is temporarily opened to provide access to the brain is called a bone flap. When the bone flap is removed from the lower back part of the skull, called the suboccipital region, the surgery is known as a suboccipital craniotomy.

Who needs a craniotomy?

A craniotomy may be needed by patients suffering from a variety of conditions within their skull including:

  • Arteriovenous malformations: Arteriovenous malformations, or AVMs, are a tangle of blood vessels that disrupt the normal flow of blood and may spontaneously bleed. A craniotomy is required if an AVM needs to be removed surgically.
  • Aneurysms: An aneurysm is a weak area in a blood vessel that causes bulging or ballooning of that vessel. A craniotomy is required if an aneurysm needs to be clipped.
  • Abscesses: A craniotomy will be needed for the removal or drainage of an abscess.
  • Blood clots or Pressure: A craniotomy is required for the removal of blood clots in the brain, like those that form after a traumatic brain injury.
  • Tumors: A craniotomy would be performed on individuals with brain tumors that required a biopsy or removal.

Before the Procedure

The patient lies on an operating table and is given general anesthesia. We position and secure their head for the procedure.

Initial Incision

Some hair may be cut to clear the incision area. The surgeon makes an incision in the skin. Next, we move aside the skin and surrounding muscles.

Exposing the Dura

The surgeon makes one or two small holes in the exposed part of the skull. With the help of a special drill, the bone is cut and the bone flap is lifted. The lifting of the bone flap exposes the dura, a covering that protects the brain tissues.

Cutting the Dura

We cut the dura to expose the brain tissues and pathology. The surgeon repairs or removes the affected tissue.

Ending the Procedure

Once the affected area is repaired or removed, the surgeon closes the dura and places the bone flap back in its original position. Tiny plates and screws are used to secure the bone flap and keep it in place. Finally, the skin is restored to its original position and sutured.

What happens after a Craniotomy is performed?

After surgery, we move the patient to an intensive care unit, or ICU, for close monitoring of their vital signs and their exam.

The patient will be periodically examined and appropriate tests and exams performed.

The patient will remain in the hospital for a period time. The duration of the postoperative stay can vary from a few days to a few weeks, depending on the reason for the craniotomy.

This material is intended to give the patient an overview of surgical procedures and treatments and is not intended to replace the advice and guidance of a physician. Always consult with your doctor about the particular risks and benefits of your treatment.

Our Physicians

Jonathan D. Chilton, MD FAANS
Geoffery L. Blatt, MD FAANS
Peter Basta, MD FAANS
Jayson A. Neil, MD FAANS
Samuel Taylon, MD, FAANS
Frances Hardaway, MD
Matthew J. Pierson, MD