A craniectomy is a neurosurgical procedure in which a portion of the skull is resected but not replaced (cf. craniotomy in which the bone flap is re-attached to the surgical defect) 1,5.
The craniectomy can be performed in the same way as a craniotomy (one or more burr holes connected by cuts, removing a section of bone) or by using rongeurs to enlarge one or more burr holes (the bone removed in small fragments) 5.
The defect is usually covered over with a skin flap. If the defect is closed by a prosthetic covering, it is known as a cranioplasty. Alternatively, the bone flap may be frozen and replaced later 5.
Indications
Craniectomies are performed in various clinical settings:
control raised intracranial pressure: see decompressive craniectomy
intraoperative cerebral swelling, which does not allow for the bone to be replaced
resection of infected bone flaps following a previous craniotomy
resection of calvarial bone infiltrated by tumor
Complications
Many of the complications of craniectomies are the same as those encountered with other surgical procedures and include infection and hematoma formation. Large craniectomies also have a number of more unique complications: see decompressive craniectomy
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