Craniotomy

A craniotomy is a surgical procedure where a piece of calvarial bone is removed to allow intracranial exposure. The bone flap is replaced at the end of the procedure, usually secured with microplates and screws. If the bone flap is not replaced it is either a craniectomy (bone removed) or cranioplasty (non-osseous surgical repair). 

Classification

There are different craniotomy approaches depending on which part of the intracranial cavity needs to be accessed ¹:

• frontal

• bifrontal

• parietal

• occipital

• pterional (i.e. frontosphenotemporal)

• subtemporal

• anterior parasagittal

• posterior parasagittal

• retrosigmoid

• medial suboccipital

• lateral suboccipital

Complications

• infection including bone flap osteomyelitis, subdural empyema and cerebral abscess

• hemorrhage

  • intracranial hemorrhage including remote cerebellar hemorrhage

  • scalp/subcutaneous hematomas

• pseudomeningocele

• tension pneumocephalus